Pallangyo Pedro, Nicholaus Paulina
Unit of Research, Jakaya Kikwete Cardiac Institute, PO Box 65141, Dar es Salaam, Tanzania.
J Med Case Rep. 2016 Dec 20;10(1):354. doi: 10.1186/s13256-016-1146-6.
Tungiasis is one of the neglected tropical diseases; it affects up to 40% of individuals living in societies with poor housing and sanitation standards. In endemic areas, Tunga infestation, which predominantly affects the periungual areas of the lower limbs in humans, is associated with considerable morbidity and poor quality of life.
A 78-year-old woman of African descent presented with pain, inflammation, suppuration, ulceration, and deformation of digits of all four limbs. She had a total of 1146 embedded sand fleas: 812 in lower limbs and 334 in her hands. She was febrile; her full blood count revealed pancytopenia and blood cultures were positive for Staphylococcus aureus and Streptococcus pyogenes isolates. Furthermore, she had severe hyponatremia. We applied 20% salicylated petroleum jelly followed by the manual removal of embedded sand fleas with a sterile needle. Intravenously administered piperacillin-tazobactam, topical ivermectin, ferrous sulfate, folic acid, tolvaptan, albendazole, multivitamins, and tetanus prophylaxis were instituted. She was discharged home after 16 days of hospitalization.
Tungiasis is a neglected disease of concern in underprivileged societies that is preventable and curable. Early recognition and prompt treatment is crucial to prevent complications in this disease which may potentially mimic other conditions resulting in erroneous management.
潜蚤病是一种被忽视的热带疾病；在住房和卫生标准较差的社区中，高达40%的人受到该病影响。在流行地区，潜蚤感染主要影响人类下肢的甲周区域，会导致相当高的发病率和较差的生活质量。
一名78岁的非洲裔女性出现四肢所有手指疼痛、炎症、化脓、溃疡及变形。她身上共有1146只嵌入的沙蚤：下肢812只，手部334只。她发热；全血细胞计数显示全血细胞减少，血培养金黄色葡萄球菌和化脓性链球菌分离株呈阳性。此外，她还患有严重低钠血症。我们先涂抹20%的水杨酸凡士林，然后用无菌针手动清除嵌入的沙蚤。给予静脉注射哌拉西林-他唑巴坦、局部用伊维菌素、硫酸亚铁、叶酸、托伐普坦、阿苯达唑、多种维生素，并进行破伤风预防。住院16天后她出院回家。
潜蚤病是贫困社区中一种值得关注的被忽视疾病，可预防且可治愈。早期识别和及时治疗对于预防该病并发症至关重要，因为该病可能会模仿其他病症从而导致错误的处理。
