Monday, December 9, 2019

Case of the Week 572

This week's cool case is from Dr. Marta Maia. The specimen is skin currettings, and the object below was viewed using a dissecting microscope. The patient had developed a firm, painful 3 mm-diameter lesion on the sole of his foot after a recent vacation in Brazil. During his vacation, we swam in the ocean and walked barefoot on the beach. Identification?

11 comments:

Unknown said...

Tunga penetrans

Danuza Mattos said...

Tunga penetrans

Unknown said...

Tunga penetrans

Unknown said...

Fleas, Tunga penetrates.

Unknown said...

Tunga penetrans

Blaine A. Mathison said...

I'm a Tunga, I'm a Tunga, I'm a Tunga, oh-oh, I'm a Tunga!

Tunga yes! Tunga penetrans? Probably. But, in Brazil, Ecuador, and Peru there is a second species infesting humans: T. trimamillata!

Bernardino Rocha said...

Agree with a hypertrophying female of Tunga sp. From Penetrans group only T. penetrans and T. trimamillata are human pathogenic, both occur in Brasil. From Caecata group there are no human pathogenic species.

Anonymous said...

Oh yes, and for sure Tunga penetrans the sand flea of Brasil.
And again, Blaine you're always so funny with your hilarious comments.
Florida Fan

Old One said...

We certainly don't see many Tunga up here in the frozen northlands. We do however see something similar in the guise of a seasonal animated character called Frosty The Snowman. Both have button noses (upturned point on head), two eyes made out of coal (opaque black eyes) and both have a large spherical body. I understand that at some point they both can cause a lot of dancing around.

Thanks all for educating this lowly Norseman on what sounds like a wonderfully nasty parasite.

Anonymous said...

Tungiasis is one of our favorite words as sounds very nasty and rolls off the tongue very nicely.

Santiago said...

Clinical history and morphology are consistent with Tunga spp; penetrans or trimamillata... besides geographic considerations, I am not sure how to differentiate the two species. In endemic areas, such as Brazil (and Venezuela!), the chronic inflammation in Tungiasis causes debilitating and incapacitating sequels. Unfortunately, medical treatment is ineffective, and prevention is thus the best way of controlling the disease; shoes and solid floors help to avoid direct contact with the soil, preventing the parasite from penetrating the intact skin. But who wants to wear shoes at the beach? (Maybe also run a stool O&P and look for hookworm eggs in this patient!) Very cool case. Thank you for sharing!
Santiago