Tungiasis - International Travel
It is found in Africa, India, and Central and South America. It is usually acquired on the feet while walking barefoot on sand or in shady areas near rotting vegetation. Children are at higher risk (peak age of incidence is 5-10 years), and boys are at slightly higher risk than girls. Poverty is a known risk factor.
Because the flea cannot jump very high, involved sites are usually limited to the feet, especially periungually. However, in small children, ectopic sites above the waist are not uncommon.
It initially presents as tender papules and nodules periungually on the feet within 24 hours after exposure. Within a week, the flea matures and swells to a diameter of one centimeter with up to 200 ova. The site becomes painful after 2-3 days.
If left untreated, the site becomes very pruritic, causing the host to scratch at the lesions, which results in rupture of the flea and dissemination of the eggs. The lesion will then become desiccated and leave a small scar.
Treatment is warranted because untreated lesions can result in bacterial superinfections.
B88.1 – Tungiasis [sandflea infestation]
64612002 – Tungiasis
- Myiasis – Lesions are usually larger
- Verruca vulgaris – Lesions are more verrucous
- Ingrown toenail – More erythematous and indurated
- Acute paronychia – More erythematous
- Mycotic granulomas – More diffuse lesions
- Melanoma – Pigment usually extends further
- Arthropod bites – Usually lack the central punctum or black dot
- Bartonellosis – Longer time frame
- Squamous cell carcinoma – Longer time frame