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tungiasis

ICD-10 Codes

Related ICD-10:

N44.1 L49.3 T32.20 S20.462 L97.501 K14 S85.152 R39.8 T32.11 L98.42 B43.0 S30.86 L02.8 S00.449 Z11 M53 A51.46 B83.8 I82.54 A66.6 B64 N47 B76.1 A28 H02.824 T24.739 T63.41 A26.7 A67.0 N99.521 S40.859 L66.3 L97.32 D50.8 A59.0 S60.454 S91.25 S00.26 S70.259 S60.36 W44.B1 Z20.7 S90.446 S90.47 T36.4X5 S50.829 L97.20 S40.85 S60.879 W44.E1 A51.43 S40.86 B35.8 B74.4 L97.811 L49.2 R46.8 B68 B74.8 T32.97 H61.122 N90.8 A84.1 K14.9 A75.0 S31.835 S90.455 S00.85 S10.17 L49.5 S85.141 K62.6 L89.152 K08 S20.16 L98.41 S70.37 L04.1 S31.43 S30.871 H02.812 M89.8X9 S10.96 S50.87 T32.40 B36.8 S40.27 T37.8X5 S00.25 S30.815 S60.322 B08.79 B87.81 S01.349 L97.3 B08.6 S00.37 A66.4 S80.841 L02.612 L89.306 R87 M94.8X6 S90.465 S90.473 S40.271 S90.872 S91.342 A66.7 H02.056 M24.074 T21.46 K61 Q52.7 S30.84 S70.221 S00.47 S70.362 E79.89 T32.3 T32.33 K13.29 S70.311 L53.3 B87.9 W44.F4 G51.2 A58 B81 S30.877 S90.84 S90.842 S01.441 S30.8 S90.521 S70.342 K12.2 S00.45 S30.855 S85.15 S40.251 S90.879 H02.814 B71.8 B08.7 S40.272 S60.479 S60.427 S00.471 S90.859 S30 L97.523 T32.87 S60.579 T32.90 T32.50 T32.82 L02.411 T32.64 T32.60 S60.37 T17.49 T32.54 M02.3 Z11.3 B71.9 B88.3 T24.431 M12.80 S90.472 S30.873 S70.222 M60.078 K01.0 W49.04 S50.821 T32.10 T37.95 S90.852 S60.457 W44.B9 S40.261 S41.141 N76.8 M85.669 S90.423 S80.272 S31.24 S80.252 S30.850 L74.2 S30.826 B83 K61.31 S90.421 B83.0 S90.572 A07.8 T63.413 B55.0 S30.824 C84.11 S70.379 B85.3 S60.57 S00.552 S95.29 S30.825 D69.8 S40.872 B72 I82 S00.522 S50.851 R87.5 M24.04 L97.12 L98.412 S20.361 H70.201 M24.076 N63.3 M86.161 T21.65 S71.041 S90.579 B08.71 B80 A25.0 S30.817 S60.56 L51.1 M71.022 S30.23 L02.11 M85.67 B55.1 H02.855 A28.8 W57 S60.369 S60.85 L03.326 B88.1 S50.85 S80.222 A74 B86 S70.341 O86.19 S40.279 H02.725 M85.661 S41.149 M43.8X3 S90.412 B85.1 S31.000 S85.14 L97.50 L97.502 S20.459 Q38.3 B56.9 L89.156 A59.9 L97.503 H02.821 L97.311 S00.479 L97.11 A67.3 L02.32 B71 T63.414 T17.398 L74.0 T22.662 S50.859 M71.012 S60.35 S01.34 S91.34 S70.322 S90.454 L02.9 L98.423 S92.202 B47.1 S01.502 S20.92 L89.316 A59.00 B55 S70.25 S31.34 S60.468 H02.822 T32.81 S90.522 S90.445 S90.559 T32.41 S40.871 S00.269 B08.69 S30.874 A51.39 S90.475 S60.351 T17.300 B60.8 Q82.8 K09.9 S90.86 S60.453 B08.70 S60.851 S90.422 R09.A1 T32.73 A44.9 S00.261 S60.861 S80.27 T32.22 Q84.8 S70.371 S31.001 L89.326 L02.235 L97.922 I87.9 S80.82 L89.626 T32.80 T21.77 B68.0 S80.852 L02.225 S70.269 T32.75 S50.862 S80.859 B88.0 S80.262 B83.3 B08.02 E72.8 Z20.2 S91.146 S00.46 S60.428 S80.879 S70.262 B56 S70.329 T32.70 S60.429 L94.8 S00.32 N82.5 R22.0 M24.052 S70.352 S70.372 L44.8 S90.869 B88.2 I82.543 W45.0 T32.65 K09.8 B08.60 B42.1 L97.101 T32.42 L97.202 N50.8 B43.2 H15.821 C91.51 R22.32 M60.27 S90.569 L49.4 S90.452 S90.529 S60.465 B55.9 M84.851 B71.1 L74.1 L98.424 M71.071 T25.429 L02.216 S31.44 S50.822 S91.349 S60.455 H02.852 S30.852 T32.43 M85.679

Description

What is Tungiasis?

Tungiasis, also known as pulga de areia, niguá, pique, bicho do pé, or jatecuba, is a skin infestation caused by the burrowing female sand flea, Tunga penetrans. This condition is characterized by immense pain and itching, difficulty walking, sleeping, and concentrating on school or work.

Symptoms of Tungiasis

The symptoms of tungiasis include:

  • Intense pain and itching at the site of infestation
  • Difficulty walking due to discomfort and pain
  • Sleep disturbances due to itching and discomfort
  • Concentration problems in school or work

Physical Characteristics of Tungiasis

The lesions caused by the flea are characterized by a white patch with a black dot in the centre. This is a distinctive feature of tungiasis, making it easier to diagnose.

Prevalence of Tungiasis

Tungiasis is prevalent in tropical parts of Africa, the Caribbean, Central and South America, and sub-Saharan Africa. In Trinidad, for example, the peak infestation rate among males aged 25-35 years is 54%. Similar trends are observed in other regions.

Neglected Tropical Disease

The World Health Organization (WHO) has recognized tungiasis as a neglected tropical disease [4]. This classification highlights the need for increased awareness and attention to this condition, which affects a broad range of domestic and livestock animals.

Citations:

  • [1] - Tungiasis is caused by adult female sand fleas, which burrow into the skin mostly of the feet.
  • [3] - Tungiasis is an inflammatory skin disease caused by infection with the female ectoparasitic Tunga penetrans.
  • [4] - WHO has recognized tungiasis as a neglected tropical disease.
  • [5] - The lesions caused by the flea are characterized by a white patch with a black dot in the centre.

Additional Characteristics

  • Tungiasis
  • Pulga de Areia
  • Niguá
  • Pique
  • Bicho do Pé
  • Jatecuba

Signs and Symptoms

Common Signs and Symptoms of Tungiasis

Tungiasis, also known as sand flea dermatitis, can manifest in various ways, making it essential to be aware of the possible symptoms.

  • Severe pruritus: Intense itching is a hallmark symptom of tungiasis, often concentrated in the area where the female sand fleas have burrowed into the skin.
  • Pain: Patients may experience significant pain in the affected area, which can also radiate to other parts of the body.
  • Inflammation and swelling: Redness and swelling around the lesions are common symptoms, indicating an inflammatory response to the flea bites.
  • Lesions and ulcerations: The burrowing process can lead to the formation of lesions or ulcers on the skin's surface, often with black dots in the center.

These symptoms can develop within a few weeks (4-6 weeks) in naive hosts, while re-infestation can trigger symptoms much sooner (12-48 hours). It is crucial to seek medical attention if you experience any of these symptoms, especially if they are accompanied by signs of infection or open sores.

Additional Symptoms

  • Severe pruritus
  • Inflammation and swelling
  • Lesions and ulcerations
  • pain

Diagnostic Tests

Diagnostic Tests for Tungiasis

Tungiasis, a parasitic skin disease caused by the female sand flea Tunga penetrans, can be diagnosed through various methods.

  • Visual Inspection: The most common method of diagnosis is visual inspection, where healthcare providers look for signs of fleas and their eggs in lesions (1). This method is often used in regions where tungiasis is prevalent.
  • Identification of Adult Fleas and Eggs: Laboratory diagnosis involves identifying adult fleas and their eggs in lesions, which confirms the presence of the parasite (2).
  • Clinical History and Physical Examination: Diagnosis can also be made by taking a clinical history and performing a physical examination, followed by confirmation through identification of the organism after removal (9).

It's worth noting that there are no specific diagnostic tests for tungiasis, as the symptoms are often visible and the parasite is ectoparasitic (6). However, in vivo and ex vivo dermoscopic examination of the lesion can aid in diagnosis (7).

References:

  • [1] Healthcare providers who provide care in regions where tungiasis is prevalent can diagnose the condition by examining the skin.
  • [2] Identification is made by the finding of adult fleas and their eggs in lesions.
  • [6] This is most likely because the parasite is ectoparasitic with visible symptoms.
  • [7] The diagnosis of tungiasis is clinical, but it can be aided by in vivo and ex vivo dermoscopic examination of the lesion.
  • [9] Diagnosis is made by the clinical history and physical examination. Confirmation is made by identification of the organism after removal.

Additional Diagnostic Tests

  • Visual Inspection
  • Identification of Adult Fleas and Eggs
  • Clinical History and Physical Examination

Treatment

Treatment Options for Tungiasis

Tungiasis, also known as sand flea disease, is a painful and itchy skin condition caused by the penetration of female sand fleas into the skin. While there is no standard treatment for tungiasis, various drug treatments have been investigated to manage this condition.

  • Topical Treatments: Topical anti-parasitic medications such as ivermectin, metrifonate, and thiabendazole have been shown to be effective in reducing the number of lesions caused by embedded sand fleas [5]. A formula of two dimeticone oils with low viscosity (NYDA) has also been found to be highly effective and safe for topical treatment [9].
  • Oral Drugs: Oral drugs such as niridazole, ivermectin, and thiabendazole have been used to treat tungiasis. A clinical trial of 106 individuals with tungiasis showed that treatment with NYDA caused no observable adverse effects [1]. Ivermectin has also been found to be effective in reducing the number of lesions caused by embedded sand fleas [5].
  • Other Options: In addition to these treatments, other options such as surgical extraction and the use of tea tree oil have been proposed. However, more research is needed to confirm their effectiveness.

Important Considerations

It's essential to note that tungiasis can be complicated by secondary infections and local tissue destruction. Adequate treatment is crucial, especially in vulnerable populations. Potential treatment options should be carefully considered based on individual circumstances.

References:

[1] Clinical trial of NYDA for the treatment of tungiasis [5] Efficacy of topical ivermectin, metrifonate or thiabendazole in reducing lesions caused by embedded sand fleas [9] Topical treatment with a formula of two dimeticone oils with low viscosity (NYDA)

Recommended Medications

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Differential Diagnosis

Differential Diagnosis of Tungiasis

Tungiasis, also known as sand flea dermatitis or creeping eruption, is a cutaneous parasitic infestation caused by the burrowing of fleas into the skin. When diagnosing tungiasis, it's essential to consider other conditions that may present similar symptoms.

Conditions to Consider in Differential Diagnosis:

  • Bacterial skin infections (impetigo): Impetigo is a highly contagious bacterial infection that can cause red sores or patches on the skin.
  • Bacterial and fungal paronychia: Paronychia refers

Additional Differential Diagnoses

Additional Information

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A parasitic ectoparasitic infectious disease that is an inflammatory skin disease caused by the parasitic infestation of the female chigoe flea, Tunga penetrans in animals and humans. The symptoms include skin inflammation, severe pain, itching, and a lesion at the site of infection that is characterized by a black dot at the center of a swollen red lesion, surrounded a white halo.
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