Disseminated tungiasis in a 78-year-old woman from Tanzania: a case report

Abstract

BackgroundTungiasis is one of the neglected tropical diseases; it affects up to 40% of individuals living in societies with poor housing and sanitation standards. In endemic areas, Tunga infestation, which predominantly affects the periungual areas of the lower limbs in humans, is associated with considerable morbidity and poor quality of life.Case presentationA 78-year-old woman of African descent presented with pain, inflammation, suppuration, ulceration, and deformation of digits of all four limbs. She had a total of 1146 embedded sand fleas: 812 in lower limbs and 334 in her hands. She was febrile; her full blood count revealed pancytopenia and blood cultures were positive for Staphylococcus aureus and Streptococcus pyogenes isolates. Furthermore, she had severe hyponatremia. We applied 20% salicylated petroleum jelly followed by the manual removal of embedded sand fleas with a sterile needle. Intravenously administered piperacillin-tazobactam, topical ivermectin, ferrous sulfate, folic acid, tolvaptan, albendazole, multivitamins, and tetanus prophylaxis were instituted. She was discharged home after 16 days of hospitalization.ConclusionsTungiasis is a neglected disease of concern in underprivileged societies that is preventable and curable. Early recognition and prompt treatment is crucial to prevent complications in this disease which may potentially mimic other conditions resulting in erroneous management.

Very severe tungiasis in Amerindians in the Amazon lowland of Colombia: A case series

“…People rest in the hammock with a hand, an elbow, the lateral rim of the foot and/or the knee outside very close to the floor and place these body areas from time to time on the ground. By consequence, rather large areas of the skin are exposed to sand fleas which, in turn, explains the high parasite burden and the ectopic localizations (Figs 1B, 1C, 2B and 3B) [41, 42]. Since tungiasis of the feet impairs mobility due to severe pain, a vicious cycle develops in embedded sand fleas accumulating over time eventually resulting in very severe tungiasis and total immobility, if patients do not have access to treatment.…”

“…penetrans sucks blood almost permanently. Third, significant anemia was present in a very severe case of tungiasis from Tanzania with about 1,100 lesions [42]. With a persistent high parasite burden, the chronic blood loss will be substantial over time and eventually results in life-threatening anemia.…”

Measuring educational neglect using the Q method: A model based on the burden of disseminated tungiasis

“…It is a common disease in developing countries and can usually be mitigated by basic environmental actions including education, physical protection and the use of repellents such as zanzarin ( 8 , 9 ). However, disseminated cases can disproportionately affect those in poor communities, leading to patients with more than 100 lesions and resulting in secondary infections and deformities ( 8 , 10 ). Most people are unaware that tungiasis can progress to such severe outcomes, but these cases have been found in remote communities in South America and Africa ( 10 ).…”

“…However, disseminated cases can disproportionately affect those in poor communities, leading to patients with more than 100 lesions and resulting in secondary infections and deformities ( 8 , 10 ). Most people are unaware that tungiasis can progress to such severe outcomes, but these cases have been found in remote communities in South America and Africa ( 10 ). Thus, tungiasis is an interesting model for testing the relationship between the various academic degrees of participants and the educational neglect in countries where the disease is endemic.…”