Tunga Penetrans in a Sub-Saharan African Desert Traveler.

A 30-year-old man complained of an itching toe two months after a backpacking trip through South Africa, Namibia, Zambia, and Tanzania to Kenya; he had walked through the Namib desert in Namibia bare-foot. On a physical examination, his right second toe, which he had torn the skin off himself to alleviate itchiness, was swollen, purplish and mildly tender (Picture 1). The pain was relieved following a small incision, which revealed the presence of several small eggs [Picture 2; digital camera macro shot (PowerShot S90; Canon, Tokyo, Japan)]. He was diagnosed with tungiasis, a parasitic infection caused by female Tunga penetrans fleas that lay their eggs on human skin. Subungual and interdigital areas are frequent infection sites exposed by walking bare-foot (1,2). Although this infection is common in residents of the sub-Saharan African desert, T. penetrans infection is scarce in Japan, Europe, and North America. Increasing opportunities to visit Africa due to globalization will increase the likelihood of tungiasis as a potential travel infection.

Picture 1.

Picture 2.

The author states that he has no Conflict of Interest (COI).