Tungiasis in New York

Authors

  • Helen Mashek MD,

    1. From the Department of Dermatology, State University of New York at Buffalo, and the Buffalo General Hospital, Buffalo, New York
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  • Barbara Licznerski MD,

    1. From the Department of Dermatology, State University of New York at Buffalo, and the Buffalo General Hospital, Buffalo, New York
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  • Stephanie Pincus MD

    Corresponding author
    1. From the Department of Dermatology, State University of New York at Buffalo, and the Buffalo General Hospital, Buffalo, New York
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, Stephanie Pincus, MD, Department of Dermatology, Buffalo General Hospital, 100 High Street, Buffalo, New York 14203

Abstract

A 33-year-old African woman was evaluated for tender nodules on her feet. Accompanied by her four children, she had recently immigrated from Somalia. Before her immigration, she resided in a Kenyan refugee camp for approximately 1 year, where she walked barefoot in sand and dirt. The patient stated that she and her four children, as well as many people living in the same compound, had similar, tender lesions on their feet. Her children were “treated” by their grandmother, who removed the contents of their lesions with a safety pin.

On physical examination the patient had numerous tender, isolated, and clustered hyperkeratotic, crusted papules, measuring 4–6 mm, on the plantar and periungual surfaces. Several lesions were ulcerated (Figs 1 and 2). The hyperkeratotic masses were debrided with a surgical blade. An intact, white, coiled structure was curetted from each papule, leaving numerous empty crater-like lesions (Fig. 3), which were identified on histologic sections as Tunga penetrans. Microscopic examination of unstained specimens showed branching, thin, translucent tubular structures with numerous eggs. Ring-shaped cross-sections of the organism's respiratory and digestive tracts were seen on hematoxylin and eosin stain (Fig. 4).

The patient received a 10-day course of dicloxacillin and topical bacitracin ointment. All lesions were healed within 1 week of therapy.

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