Ectopic localization of tungiasis.

Abstract

Abstract. Tungiasis is caused by the penetration of the female sand flea Tunga penetrans into the epidermis. It is generally assumed that lesions are confined to the feet. To determine to what degree tungiasis occurs at other topographic sites, 1,184 inhabitants of a poor neighborhood in northeastern Brazil were examined; 33.6% were found to have tungiasis (95% confidence interval ‫ס‬ 30.9-36.4%). Six percent presented lesions at locations other than the feet, with the hands being the most common ectopic site (5.5%). Other sites were the elbows, thighs, and gluteal region. Ectopic tungiasis was significantly associated with the total number of lesions (P < 0.001) and an age less than 15 years old (P ‫ס‬ 0.02). In 86 patients actively recruited with lesions on their feet, ectopic localizations were observed in 25.6%. Since untreated sand flea lesions are prone to become superinfected, clinicians should be aware of not missing any ectopic localization of tungiasis.

An Ectopic Case of Tunga spp. Infection in Peru

“…17 The most common ectopic topography appears on the hands, although it has been observed on the thigh, elbow, breast, inguinal areas, gluteal region, trunk, abdomen, face, eyelid, testes, penis, pubis, and wrist. 2,5,9,18,19 Our case is the first human tungiasis located on the knee, an unusual area.…”

“…17,20 As a result, the most common site of penetration is the foot. However, Heukelbach and others 9 have observed that fleas are able to run across the skin at speeds of 10 mm/second, and this may explain the atypical sites of parasitism. 9 Whereas ectopic tungiasis presents almost exclusively in patients with multiple lesions, the case reported here is a child who presented with an isolated ectopic lesion.…”

“…In poor neighborhoods such as the favela of Serviluz, Fortaleza, Brazil, where the infestation level is high, the prevalence of ectopic tungiasis may be up to 5.5%, and it mostly affects the hands of children under 15 years old. 9 In an outbreak of tungiasis in rural Haiti, only 11.36% of 132 individuals infected had the flea appear in locations other than the feet. 17 The most common ectopic topography appears on the hands, although it has been observed on the thigh, elbow, breast, inguinal areas, gluteal region, trunk, abdomen, face, eyelid, testes, penis, pubis, and wrist.…”

“…However, the majority of case series and in particular, one of the largest case series from an endemic area reported that the prevalence of ectopic tungiasis is 6%. 8,9 Tungiasis can be a crippling disease, leading to secondary superinfection with other bacteria, cellulitis, abscess, tetanus, auto-amputations, thrombophlebitis, and sepsis. 9,10 We present a rare case of knee tungiasis diagnosed by an excisional biopsy, and this information reflects the disinterest and lack of knowledge of this ectoparasitism among health-care providers in areas of Lima, Peru.…”

Tungiasis, una enfermedad tropical emergente en Chile: Comunicación de tres casos clínicos importados

“…En forma esporádica y habitualmente en niños se ha comunicado el compromiso en otras zonas como manos, codos, muslos, glúteos y párpados. Esto se explica por la menor estatura y, por lo tanto, la mayor capacidad del parásito de alcanzar segmentos corporales superiores 8 . Una vez que la hembra grávida penetra en la epidermis produce cientos de huevos mientras se alimenta de la sangre de su hospedero.…”