Clinical and Laboratory ObservationsTungiasis in North America: A report of 2 cases in internationally adopted children☆
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.
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Hurwitz Clinical Pediatric Dermatology, Fouth Edition
2011, Hurwitz Clinical Pediatric Dermatology, Fouth EditionImported human tungiasis in Greece
2009, Travel Medicine and Infectious DiseaseTungiasis and myiasis
2007, Clinics in DermatologyCitation Excerpt :In nonendemic areas, tungiasis is rare and usually appears on travelers returning from endemic areas. It has been documented in numerous countries, mainly in Europe, because of tourism to tropical and subtropical regions.6,14-17 There are isolated reports of infection acquired in nonendemic countries, most likely by fleas that were imported and completed their free-living life cycle at sites such as sandy beaches on the Mediterranean Coast.8,18
Immunizations and infectious disease screening for internationally adopted children
2005, Pediatric Clinics of North AmericaAcute care issues in internationally adopted children
2004, Clinical Pediatric Emergency Medicine
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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.