ABSTRACT
Resumen | La tungiasis es una ectoparasitosis endémica en Latinoamérica y está asociada a factores de riesgo como la ruralidad, la pobreza y la convivencia con animales. Popayán, una ciudad al suroccidente de Colombia, fue históricamente afectada por la tungiasis, tanto así que a sus habitantes los apodan "patojos" debido a la forma de caminar de sus habitantes infestados por la pulga. Hoy la enfermedad se creía eliminada. Se presenta el caso de un niño de 12 años procedente del área urbana de Popayán, que consultó por lesiones papulares de bordes circulares, centro negruzco y halo hiperqueratósico en ambos pies, de un mes de evolución. Por los hallazgos clínicos se sospechó tungiasis y se le administró ivermectina. Las lesiones se removieron quirúrgicamente y se enviaron para análisis parasitológico, el cual confirmó la presencia de Tunga penetrans. La evolución del paciente fue satisfactoria. La Secretaría de Salud Municipal de Popayán inspeccionó el domicilio del paciente y encontró perros migrantes del Pacífico colombiano en sus alrededores, algunos con lesiones sospechosas de tungiasis. Se documenta, así, el resurgimiento de esta enfermedad en el área urbana, probablemente debido a la migración de animales desde las zonas rurales. Es importante reconocer la existencia de la pulga en zonas rurales y urbanas, hacer el diagnóstico médico y reportar los casos a los entes de vigilancia. Estas acciones permitirán ofrecer un apropiado manejo y control sanitario de esta ectoparasitosis desatendida en humanos y animales.
Abstract | Tungiasis is an endemic ectoparasitosis in Latin America associated with risk factors such as rurality, poverty, and living with animals. In Popayán, a city in southwest Colombia, the disease was highly prevalent in the past, to such degree that its inhabitants were given the nickname of patojo, a word that describes the way of walking of people infested by the flea. However, it was believed eradicated at present. We present the case of a 12-year-old boy living in the urban area of Popayán, who presented with a one-month history of papular lesions with circular edges, blackish center, and hyperkeratotic halo on both feet. Tungiasis was suspected based on the clinical findings and ivermectin was administered. The lesions were surgically removed and sent for parasitological analysis, which confirmed the presence of Tunga penetrans. The patient evolved satisfactorily. The Secretaría de Salud Municipal de Popayán carried out an inspection of the patient's home where migrant dogs from the Colombian Pacific were found in the surroundings, some with suspicious lesions of tungiasis. We document here the resurgence of this pathology in urban areas, probably secondary to the migration of animals from rural areas. It is important to recognize the existence of the flea in rural and urban areas, make a medical diagnosis, and report cases to the surveillance entities to enable appropriate management and sanitary control of this neglected ectoparasitosis in humans and animals.
Subject(s)
Tungiasis , Parasites , Colombia , TungaABSTRACT
RESUMEN Latungiasisesuna ectoparasitosistransitoria en el ser humano, que se produce a causa de la penetración en la piel de la hembra grávida de la "pulga de arena", Tunga penetrans. También es conocida como "nigua", "bichodopé", "sandflea",entre otras denominaciones. Es una enfermedad endémica en áreas rurales y playas de Centro y Sudamérica, Caribe y África Subsahariana. En Argentina se la encuentra en zonas del Noreste y Mesopotamia. Debido al incremento de los destinos vacacionales a dichas regiones tropicales, comenzaron a observarse casos de tungiasis fuera de las áreas endémicas (casos importados). Comunicamos el caso de una niña argentina, que vacacionó en las playas caribeñas y adquirió la infestación por Tunga penetrans, la cual evolucionó de manera llamativa, manifestando un fenómeno isotópico.
SUMMARY Tungiasis is a transitory ectoparasitosis caused by penetration into the skin of the female flea Tungapenetrans, also known as "nigua", "bichodo pé", or "sand flea". It's an endemic disease that can be found at rural zones, Caribbean beaches and Sub-Saharan Africa. In Argentina, it's distributed in the northeastand Mesopotamia. Because of the increasement of holiday destinations, in these tropical regions, cases of tungiasis were reported outside the endemic areas. People who went to those zones, carried the disease to their birthplaces (imported Infestations). We report the case of a little Argentinian girl who went to a Caribbean beach and acquired the infestation by tungapenetrans, which made its develop in a striking way; showing an isotopic phenomenon.
ABSTRACT
Abstract: The authors report an unusual case of disseminated tungiasis in a 52-year-old patient living in the city of Campo Grande, state of Mato Grosso do Sul, who had crusted-papular-nodular lesions located in feet, hands, and right thigh. Diagnosis was confirmed by dermoscopy and anatomopathological examination.
Subject(s)
Humans , Male , Middle Aged , Tungiasis/diagnostic imaging , Dermoscopy , Tungiasis/drug therapyABSTRACT
La tungiasis es una ectoparasitosis causada por la penetración en la piel de la pulga hembra Tunga penetrans. Esta enfermedad no es específica del hombre y se distribuye en regiones cálidas y secas alrededor del mundo. Se adquiere por contacto directo con el suelo en donde habitan los parásitos adultos. En zonas endémicas, su alta prevalencia se asocia a pobreza y falta de acceso al sistema de salud. Además es frecuente entre viajeros que visitan regiones endémicas y que regresan a sus lugares de origen. Presentamos un caso típico de tungiasis en un paciente 39 años que había realizado un viaje reciente a zona endémica. (AU)
Tungiasis is an ectoparasitosis caused by penetration into the skin of the female flea Tunga penetrans. This disease is not human-specific and is distributed worldwide in warm, dry regions. It is acquired by direct contact with the soil where the adult parasites live. In endemic areas, its high prevalence is associated with poverty and lack of access to the health system. It is also frequent among travelers visiting endemic regions and returning to their places of origin. We present a typical case of tungiasis in a 39 year old patient who had made a recent trip to an endemic area. (AU)
Subject(s)
Humans , Animals , Male , Female , Child , Adult , Middle Aged , Aged , Tungiasis/diagnosis , Tungiasis/pathology , Argentina/epidemiology , Socioeconomic Factors , Bacterial Infections/complications , Poverty Areas , Risk Factors , Endemic Diseases , DDT/therapeutic use , Tunga/classification , Tungiasis/surgery , Tungiasis/etiology , Tungiasis/parasitology , Tungiasis/prevention & control , Travel-Related Illness , Barriers to Access of Health Services , Health Services Accessibility , Insect Repellents/therapeutic useABSTRACT
O objetivo deste artigo é revisar as características clínicas da tungíase. A Tunga penetrans é a menor das pulgas conhecidas, alcançando 1 milímetro de comprimento quando atinge a fase adulta. Os relatos antigos de surtos de tungíase são escassos em relação aos registros epidemiológicos. O diagnóstico da doença é realizado através da história epidemiológica e dos achados clínicos, aliados ao exame direto com visualização do parasita, após abertura da lesão com agulha estéril. A retirada da pulga é o tratamento preconizado, sendo a profilaxia a melhor alternativa para controlar o parasita. Os profissionais de saúde devem atentar para a importância de se orientar as populações de áreas endêmicas em relação à doença, a fim de reduzir o número de casos e de complicações.
The purpose of this article is to review the clinical features of tungiasis. Tunga penetrans is the smallest known flea, reaching a millimeter in length when fully grown. The earliest accounts of outbreaks of tungiasis are scarce in relation to epidemiological records. The diagnosis is made by history and clinical epidemiological findings, coupled with the direct examination with visualization of the parasite after opening the wound with a sterile needle. The removal of the flea is the recommended treatment, and prophylaxis the best way to control the parasite. Healthcare professionals should be aware as to the importance of educating the public in endemic areas for the disease in order to reduce the number of cases and complications.
Subject(s)
Humans , Tungiasis/diagnosis , Tungiasis/drug therapy , Thiabendazole/administration & dosage , Disinfection , Mercury/administration & dosageABSTRACT
Tungiasis is a cutaneous ectoparasitosis caused by the sand flea Tunga penetrans whose higher prevalence occurs in South America, the Caribbean and Sub-Saharan Africa. It is clinically characterized by a papular lesion, either single or multiple, with a whitish halo and a brown-black central core, most of them localized on the feet. The lesions can be painful and itchy with the most common complication being bacterial superinfection of the skin. We report three cases of Chilean patients who presented skin lesions suggestive of tungiasis on their return from areas of high prevalence of the disease. The diagnosis is made by the clinical features of lesions in a patient from an endemic zone. Standard treatment consists of surgical extraction of the flea followed by application of a topical antibiotic and a tetanus prophylaxis. Prevention of the infestation is essential and includes the use of closed footwear and repellents.
La tungiasis es una ectoparasitosis cutánea causada por la pulga Tunga penetrans, prevalente en Sudamérica, el Caribe y África Subsahariana. Clínicamente se caracteriza por la formación de pápulas, únicas o múltiples, con un halo blanquecino translúcido y una región central pardo-negruzca, frecuentemente localizadas en los pies. Las lesiones pueden cursar con prurito o dolor leve, siendo la sobreinfección bacteriana la complicación más frecuente. Se comunican tres casos clínicos de chilenos que viajaron a zonas de alta prevalencia de tungiasis y que a su regreso presentaron lesiones dérmicas sugerentes de la enfermedad. El diagnóstico se realizó en base a las características clínicas de las lesiones en un paciente proveniente de zonas endémicas. El tratamiento de elección es la extracción quirúrgica de la pulga seguido del uso de antimicrobianos tópicos y la vacunación antitetánica. La prevención es esencial con el uso de calzado cerrado y repelentes.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Tungiasis/diagnosis , Chile , Travel , Tungiasis/surgeryABSTRACT
La tungiasis es una parasitosis cutánea originaria de América causada por Tunga penetrans. Se caracteriza por lesiones papulares, negruzcas, únicas o múltiples, que suelen afectar los pies, principalmente en las zonas subungueales y periungueales. El diagnóstico de tungiasis se realiza por las características clínicas de las lesiones en un paciente proveniente de zonas endémicas. El tratamiento de elección es la extracción quirúrgica de la pulga y la aplicación de antibióticos tópicos. Presentamos un caso de tungiasis en una paciente de 10 años de edad con múltiples lesiones en ambos pies, que fue tratada satisfactoriamente con ivermectina y extracción quirúrgica.
Tungiasis, is a cutaneous parasitosis, native of America caused by Tunga penetrans. Infestations usually presents with black papular lesions, either single or multiple, most of them localized on the feet, mainly in the subungual and periungual areas. Diagnosis of tungiasis is based on the characteristic aspect of the lesions in a patient coming from an endemic area. Surgical removal of the fea and application of a topical antibiotic is the standard treatment. We describe a case of a 10-years-old girl, with multiple lesions localized on feet, who was succesfully treated with ivermectin and surgical removal of lesions.
Subject(s)
Child , Female , Humans , Tungiasis , Tungiasis/diagnosis , Tungiasis/drug therapyABSTRACT
Objetivo: estimar a prevalência de tungíase e identificar os fatores associados em uma área de aglomerado subnormal de Natal-RN. Metodologia: estudo populacional, transversal conduzido de novembro de 2008 a maio de 2009. Dados foram coletados através de questionários socioambiental, clínico-epidemiológico e clínico-veterinário. Todos os 310 indivíduos residentes foram examinados. Resultados: a prevalência foi 23,2 por cento (IC95 por cento: 18,6-28,3). Fatores independentemente associados foram: sexo masculino (OR=2,9; IC95 por cento: 1,2-7,0), analfabetismo/baixa escolaridade (OR=4,1; IC95 por cento: 1,7-9,6)) e uso de calçados variando de OR=13,7; IC95 por cento: 4,3-43,9 a OR=48,8; IC95 poe cento: 10,5-227,9. Conclusão: na população estudada, a tungíase estava fortemente associada à baixa escolaridade e inadequado uso de calçados.
Objective. to estimate the prevalence and to identify the associated factors of tungiasis in a shanty town in the capital city of Natal, State of Rio Grande do Norte, Brazil. Methodology: the population study was conducted from November 2008 to May 2009, when data were collected using socioenvironmental, epidemiological and veterinary questionnaires. A total of 310 residents were examined. Results: the prevalence was 23.2 per cent (95 per cent CI 18.6 - 28.3). Factors independently associated were: male (OR 95 per cent CI 2.9, 1.2 - 7.0), illiteracy/poor education (OR 95 per cent CI 4.1, 1.7 - 9.6) and footwear OR 95 per cent ranged from 13.7 (4.3 - 43.9) to 48.8 (10.5 - 227.9). Conclusion: in that population, tungiasis was strongly associated with low education and inadequate use of footwear.
Subject(s)
Humans , Animals , Male , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Ectoparasitic Infestations , Prevalence , TrombiculidaeABSTRACT
La tungiasis es una ectoparasitosis cutánea producida por la hembra fecundada de la pulga de arena Tunga penetrans, cuya mayor prevalencia ocurre en África Sub-sahariana, Sudamérica y el Caribe. Comunicamos dos casos de pacientes que presentaron lesiones ampollares sugestivas de tungiasis al retornar de Ferrugem (Brasil) y Misiones (Argentina) respectivamente. El diagnóstico de tungiasis fue confirmado en ambos casos. Se revisa la historia, epidemiología y biología de la tungiasis. Se plantean hipótesis sobre la patogenia de la forma clínica ampollar.
Tungiasis is a cutaneous ectoparasitosis caused by the gravid femalesand flea Tunga penetrans,whose higher prevalence occurs in Sub-Saha-ran Africa, South America and the Caribbean. We report two males whopresented bullous lesions suggestive of tungiasis on their return fromFerrugem (Brazil) and Misiones (Argentina). The diagnosis of tungiasiswas confi rmed in both cases.The history, epidemiology and biology are reviewed. Some hypothesis about the pathogenesis of bullous tungiasis are suggested.
Subject(s)
Humans , Male , Ectoparasitic Infestations , Foot Diseases , Skin/pathology , Blister/etiologyABSTRACT
Tungiasis is a cutaneous ectoparasitosis caused by the female sand flea Tunga penetrans whose higher prevalence occurs in Sub-Saharan África, South América and the Caribbean. We report a case of a 23 year old chilean male who presented dermal lesions suggestive of tungiasis on his return from Brazil. The diagnosis was confirmed by biopsy, identifying the arthropod and an egg from one of the lesions. The natural history, co-morbidities and treatment options were reviewed.
La tungiasis es una ectoparasitosis cutánea producida por la hembra de la pulga de arena Tunga penetrans, cuya mayor prevalencia ocurre en África Sub-sahariana, Sudamérica y el Caribe. Comunicamos el caso de un chileno de 23 años que viajó a Brasil y que a su regreso presentó lesiones dérmicas sugerentes de tungiasis. El diagnóstico fue confirmado por una biopsia identificando el artrópodo y un huevo en una de las lesiones. Se revisa la historia natural, las co-morbilidades asociadas y alternativas de tratamiento.
Subject(s)
Adult , Animals , Humans , Male , Ectoparasitic Infestations/parasitology , Siphonaptera , Travel , Brazil , Chile , Ectoparasitic Infestations/diagnosisABSTRACT
Tungiasis is a common parasitic skin disease in Brazil, caused by the flea Tunga penetrans. We conducted a cross-sectional study to evaluate the occurrence of infestation with T. penetrans in primary schoolchildren in Criciúma, Santa Catarina State (South Brazil). In total, 917 children (6-10 years) of 68 schools were included in the study (11% of target population). Physical examination was followed by residential visits of those infested, to assess housing conditions and to interview the childrens guardians. Of the 917, 15 (1.6%) children were infested with the parasite. The prevalence was twice as high in females (10 children - 2.2%) as compared to males (five children - 1.1%), but due to the low number of infested individuals, the difference was statistically not significant (p = 0.18). The mean number of lesions found was 1.4 per child. One child presented bacterial superinfection. Of the 15 children infested, 10 (66.7%) studied in schools built on pyritiferous soil. The families of 12 children (79.9%) had been living in the area in which the study was conducted for less than eight years and were considered underprivileged families with the head of the household having a low education status. We conclude that in Criciúma tungiasis occurs in primary school children, but prevalence and parasite load are low.
Tungiasis is a common parasitic skin disease in Brazil, caused by the flea Tunga penetrans. We conducted a cross-sectional study to evaluate the occurrence of infestation with T. penetrans in primary schoolchildren in Criciúma, Santa Catarina State (South Brazil). In total, 917 children (6-10 years) of 68 schools were included in the study (11% of target population). Physical examination was followed by residential visits of those infested, to assess housing conditions and to interview the childrens guardians. Of the 917, 15 (1.6%) children were infested with the parasite. The prevalence was twice as high in females (10 children - 2.2%) as compared to males (five children - 1.1%), but due to the low number of infested individuals, the difference was statistically not significant (p = 0.18). The mean number of lesions found was 1.4 per child. One child presented bacterial superinfection. Of the 15 children infested, 10 (66.7%) studied in schools built on pyritiferous soil. The families of 12 children (79.9%) had been living in the area in which the study was conducted for less than eight years and were considered underprivileged families with the head of the household having a low education status. We conclude that in Criciúma tungiasis occurs in primary school children, but prevalence and parasite load are low.
Subject(s)
Animals , Child , Female , Humans , Male , Ectoparasitic Infestations/epidemiology , Siphonaptera , Brazil/epidemiology , Cross-Sectional Studies , Prevalence , Residence CharacteristicsABSTRACT
Tungiasis is an ectoparasitic disease that is caused by the penetration of Tunga penetrans into the epidermis of the host. Tungiasis is indigenous to South Americaand the Caribbean regions, but it has spread to Latin America, India, and sub-Saharan Africa. The area of soft skin such as the soles, toes, webs and subungual regions are the favored sites for sand flea embedding. As the flea enlarges within epidermis a pruritic, painful white or erythematous papulonodule develops. A black central punctum is characteristic. A 32-year-old woman presented with a small black crust on the right sole after traveling to an endemic area(Congo). Histopathologic examination revealed the internal organs of the arthropod embedded intothe epidermis, which allowed a definitive diagnosis of tungiasis. Although tungiasis is common in endemic areas, there has been no report of tungiasis in the Korean literature. We report herein an interesting case of tungiasis in a patient after traveling to Congo.