tungiasis; jiggers

Etiology: Tunga penetrans Epidemiology: 1) found in Central & South America & in regions of tropical Africa 2) adult chiggers live in sandy soil (size of pinpoint) Pathology: 1) the female chigger attaches to & imbeds itself in the skin especially between the toes & underneath the toenail 2) there it grows to the size of 3-4 mm 3) after releasing eggs, the female dies resulting in an inflammatory response, with occasional secondary bacterial infection Clinical manifestations: 1) lesions resemble a white pustule with a central black depression 2) lesions may be pruritic or painful Laboratory: - diagnosis of tungiasis is made by identifying the dark part of the chigger's abdomen (which display spiracles) protruding from the surface of an enlarging lesion Complications: 1) tetanus 2) bacterial infection 3) autoamputation of toes Management: - removal of intact flea with sterile needle or scalpel

References

Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 936