Tungiasis (Jiggers)

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ICD10 CODE: B88.1

An infestation by the burrowing flea Tunga penetrans. Commonly affects the feet, hands, elbows, and sometimes buttocks.

Cause

  • A burrowing sand flea, Tunga penetrans

Risk Factors

  • Travel to areas with T. penetrans
  • Walking bare feet
  • Living in same house with domestic animals such as pigs, dogs and rodents like rats

Clinical features

  • 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

Complications

  • Tissue necrosis, suppuration, gangrene
  • Disability, disfigurement

Differential diagnosis

  • Cercarial dermatitis, scabies
  • Creeping eruption (ancylostoma species)
  • Tick or flea bite, myiasis

Investigations

  • Clinical features are diagnostic

ManagementTreatment

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 Dimethicone oil for treatment of tungiasis
  • Wash the feet or the affected part of the body thoroughly with soap
  • Let the feet or body part dry
  • Apply a few drops on the black dot of the identified jiggers
  • For severe cases you may require to rubbing the oil into the crevices
  • A single treatment as above is enough but can be repeated after two weeks in situations of severe infestation

Precautions

  • Avoid contact with In case of contact, wash the eye with plenty of clean water
  • The oil is highly inflammable. Avoid sitting near open fires after applying Dimeticone.
  • Store the unused oil away from open fire and children

Contraindications:

  • Do not use dimeticone on people with known hypersensitivity reactions to any of the Dimeticone oils

OR

  • Apply benzyl benzoate 25% emulsion twice daily to the affected area for 6 days
  • 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

If secondary bacterial infection

Note: Health education to prevent secondary bacterial infections such as cellulitis, and tetanus

Prevention

  • Spray the ground with insecticide such as malathion
  • Protect feet with socks and shoes
  • Dry laundry on a line instead of the ground
  • Do not share housing with animals. Animals such as goats, pigs, cows can all be infested with jiggers
  • Keep floors clean and dust free
  • Health education