Elsevier

The Journal of Pediatrics

Volume 139, Issue 5, November 2001, Pages 744-746
The Journal of Pediatrics

Clinical and Laboratory Observations
Tungiasis in North America: A report of 2 cases in internationally adopted children

https://doi.org/10.1067/mpd.2001.118530Get rights and content

Abstract

Tungiasis is a cutaneous infestation caused by the gravid female sand flea, Tunga penetrans. We describe 2 cases of tungiasis that occurred in siblings who recently emigrated as international adoptees from Liberia to the United States. Both patients had infectious complications as a result of the infestation with T penetrans. (J Pediatr 2001;139:744–6)

Section snippets

Case 1

A 4-year-old girl was evaluated after arriving from Liberia with her new adoptive family. She had been ill for the previous 4 days with fever to 104° Fahrenheit, lethargy, vomiting, diarrhea, and a painful left fifth toe. In Liberia, she lived in an orphanage with earthen floors.

The girl’s physical examination was remarkable for cervical adenopathy, a palpable liver edge and spleen tip, and multiple, small, black, firm, punctate papules on the soles and periungual areas of both feet. In

Discussion

Tunga penetrans is known by several names, including chigoe flea, jigger flea, nigua, pico, and le Bicho de pe.4, 6 Adult T penetrans sand fleas are small (~1 mm), free-living arthropods that reside in sandy soil, beaches, and earthen floors of human dwellings.4 Common hosts include humans, dogs, cats, horses, pigs, birds, and other wild animals.8, 11 Sand fleas have limited jumping ability and primarily attack the feet, especially the soles (nonweight-bearing), toe webs, and periungual areas

Acknowledgements

We acknowledge Alicia Emley for her technical assistance in graphic design.

References (14)

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Reprint requests: Mary Allen Staat, MD, MPH, Children’s Hospital Medical Center, Division of Infectious Diseases, International Adoption Center, 3333 Burnet Ave, Cincinnati, OH 45229.

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