Tungiasis (Jiggers)

exp date isn't null, but text field is

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 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 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 petrolleum jelly vaseline) daily for 7 days

If secondary bacterial infection

• Treat as per boils

Note: Take precautions 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