Causes and risk factors
Tungiasis is caused due to a flea called Tunga penetrans. These are particularly found in warm, dry soil, or in sandy beaches or stables or stock farms. Flea requires warm blood to reproduce, hence along with human beings, pigs, cats, sheep, rats, etc., also act as host. The eggs of Tunga penetrans are found in the environment. These eggs hatch into larva. For the next 3-4 days they survive on the debris found in the environment. Tunga penetrans undergoes two larval stages. Further, it forms into pupae. Pupae then forms into an adult flea. Both male and females penetrate into the human body through unprotected skin. The feet are the most common route of entry. After entering the human body, the male and female flea mate. The female flea further penetrates into the skin where it lays hundreds of eggs and thus the cycle continues. Immune compromised people, old people, and children whose immunity is yet to build up completely are at high risk for developing the infection. Even patients who have undergone organ transplantation or taking chemotherapy or those who travel to endemic areas are at risk of developing the infection. Poor hygienic condition and poor personal hygiene contribute to the spread of the infection.
Clinical presentation
The common site of affection is the feet. The adult female flea penetrates through the skin. A white patch with a black dot at the center is formed at the site of entry. It appears like a punctum. The size of the lesion can vary from 4-10 mm. Pain and itching can be seen. Redness and swelling is seen at the affected site. Over time, ulceration can occur.
Investigations
Diagnosis is confirmed on the basis of the symptoms narrated by the patient and on examining the skin lesion. Histological examination confirms the findings of the adult flea and eggs.
Treatment
In most of the cases, the burrowed flea dies within a week or two and the skin sheds off, hence no medical intervention is needed. While in other cases, removal of the flea is done with the help of sterile needles or forceps. Topical application of antiparasitic medication is recommended. Use of thick wax and gel can also be done. Administration of oral medications can be done. Anthelmintic drugs are the drugs of choice. Along with this, certain preventive measures need to be implemented. It comprises of maintaining proper personal and environmental hygiene.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptom. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
