Tungiasis in North America.

Tungiasis, a condition rarely seen in the United States, is an infestation of the gravid female chigoe flea, Tunga penetrans. The presenting lesion is an asymptomatic, noninflammatory, translucent nodule with a central dark spot. Complications include severe itching, pain, inflammatory reaction leading to autoamputation of digits, pyoderma (cellulitis) and tetanus. Therapy consists of removal of the organism and protection against pyoderma and tetanus.