Parasite Infestation Tungiasis (Parasitologi)

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Tungiasis

Tungiasis
 Tungiasis is an infestation of the skin by a
burrowing flea called Tunga penetrans
(also known as Sarcopsylla penetrans or
Pulex penetrans, or more commonly as
the chigoe flea, bicho de pie (bug of the
foot), jigger, nigua, pico, pigue, and sand
flea. Chigoe flea is sometimes confused
with chigger or harvest mite.
Tungiasis

•Acute inflammation with


intense erythema and a
slight edema is shown.
• Lesions are located at the
lateral side of the finger and
another lesion is lifting up
the nail.
Tunga penetrans (jigger or sand flea)
Life Cycle of the Chigoe Flea
 The parasitic chigoe flea lives in warm, dry soil
and sand, and is found commonly in beaches,
farms, and wooded areas.
 Both the male and female fleas feed on warm-
blooded host, but only the impregnated female
flea anchors herself and burrows into the host's
skin.
 The chigoe flea burrows head first into the upper
dermis, with the tail-end of its abdomen forming
an orifice at the skin surface (often causing white
patch with a dark tip, bump or ulceration), which
the flea uses to breathe.
Tungiasis lesion
In about 1 to 2 weeks, the
chigoe flea becomes enlarged
(about the size of a pea) when
it becomes full with eggs. It
then lays about 100 eggs
through the skin orifice, which
fall to the ground. The flea
then dies and is slowly shed by
Flea eggs shed from the lesion.
the host. In approximately 3 to
4 days, the eggs then hatch
and become adult fleas in 2 to
3 weeks.
Host of the Chigoe Flea

 Toreproduce, the chigoe flea


requires a warm-blooded host,
such as human, cattle, sheep,
horse, pig, rat, and dog.
Symptoms of Tungiasis
 The symptoms of chigoe flea infestation include:
 Extreme itching
 Pain
 Inflammation
 Fibrous cyst
 Bumps, lesions or nodules (in form of white or
red patches with dark spots)
 Ulceration, especially in heavy infestation
 Discharge from the ulcer or bump
 In heavy infestation, ulceration and fibrosis can
occur. Left untreated, secondary infection such
as bacteremia, tetanus and gas gangrene can
occur.
Because the flea has
limited jumping ability, the
most common site of
infection in human is the
feet, especialy in the areas
between the toes and
around the toenails.
Severe tungiasis of the toes.
Prevalence of Tungiasis

Tungiasis is found mainly in the


Africa, especially in Nigeria, the
Caribbean, especially in Trinidad,
Central and South America, and
India.
Prevention of Tungiasis

 Infection by chigoe flea can be


effectively prevented by wearing
shoes and spraying insecticides in
affected areas.
Tungiasis Treatment
 The treatment options for chigoe flea infestation include:
 Cryotherapy
Similar to cryotherapy for wart, a freezing solution of
liquid nitrogen is applied to "freeze" the tungiasis
nodule.
 Topical medicine
Topical anti-parasitic medicine, such as ivermectin
(stromectol) can be used.
 Anti-parasitic drugs
Drugs such as niridazole has been successfully used to
kill embedded fleas in adults and children.
 Petrolatum solution
Another option is to put a thick layer of petrolatum (liquid
paraffin or mineral oil) to suffocate the flea.
 Removal by forcep
When the flea is close enough to the surface, a
forcep or a needle can be used to gently remove it
from the skin.
 Surgery
If the flea is engorged with blood, it may be difficult
to remove with a forcep. Here, a minor surgery
using a curette to excise the nodule may be
necessary.
After removal of the chigoe flea, topical antibiotics
are applied to the wound. Broad spectrum
antibiotics and tetanus shot may also be given to
prevent secondary infections.

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