Tungiasis (jiggers)
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Burrowing, fungal infestation of the feet, hands, elbows, and sometimes buttocks.
Cause
- Sand flea, Tunga penetrans
Signs and symptoms
- Punctum or ulceration, often described as a white patch with a black dot on affected area
- There may be redness and swelling around affected site
- A serosanguineous exudate may ooze from the central opening, and eggs may be seen with the naked eye
- Lesions can be painful and very itchy
- Loss of toe nails and deformed toes
Differential diagnosis
- Cercarial dermatitis
- Scabies
- Creeping eruption (ancylostoma species)
- Tick or flea bite - myiasis
Complications
- Tissue necrosis, suppuration, gangrene
- Disfigurement, disability
Investigations
- Diagnosis is clinical
Treatment objectives
- Treat the infection
- Prevent complications
Non-pharmacological/pharmacological Treatment
Self-healing In many cases, tungiasis will heal on its own as the burrowed flea dies within 2–5 weeks, and naturally sloughs off as the skin sheds Surgical removal Physical removal of the flea using sterile forceps, or needles, or safety pins Medicine treatment and suffocation of flea Apply benzyl benzoate 25% emulsion twice daily to the affected area for 6 days OR Apply calamine lotion to relieve pruritis Immerse affected area in potassium permanganate 0.05% once a day for 10 minutes for 10 days Then follow with application of thick petroleum jelly or 20% salicylated petroleum jelly (Vaseline) daily for 7 days |