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Tungus, a tropical disease badociated with poverty, is caused by the penetration of female sand fleas into a person's skin, usually in his toes or feet. This week in PLOS Neglected Tropical Diseases, researchers report five cases of severe tungiasis to illustrate how the disease can evolve into a vital threat.
When the female with sand fleas (Tunga penetrans or Tunga trimamillata) gets into the skin, it starts to grow quickly. Within a few days, this growth causes intense inflammation accompanied by pain and itching. As a general rule, once all the eggs are expelled into the environment through a tiny hole in the skin and the parasite is dead, the symptoms regress. But in endemic areas, people are frequently re-infected and end up with hundreds, if not thousands, of embedded sand fleas. While mild cases of tungiasis with some built-in sand chips can be treated surgically (if adequate sanitary infrastructure is available), in the case of a very serious tungus, surgical removal of the included sand fleas does not occur. Is not possible.
In the new work, Hollman Miller of the Vaupés Health Department in Colombia and his colleagues studied five patients living in the traditional Amerindian communities of the Amazonian lowlands of Colombia, all with very severe tungiasis. Four of the patients were seen in the Emergency Department of Mitú Hospital, one in the community in which she lived.
The patients, who were all partially or totally immobile, each had between 400 and 1,300 sand chips penetrated into the feet, ankles, knees, elbows, hands, fingers and around the anus. Two patients were cachectic, with weight loss and muscle loss; one suffered from severe malnutrition; and a person needed a blood transfusion because of severe anemia. The authors show that a typical pattern of pre-existing medical conditions and socio-economic and environmental factors determines whether tungiasis evolves into a threat to life. In addition, they confirmed that the combination of two dimeticone oils in a medical device called NYDA (previously used to treat lice) effectively kills hundreds of encrusted sand chips, which resolves inflammation and restores mobility In a week.
"Our results are a good argument for launching a call for action for countries in which tungosis occurs in remote areas and where health coverage is poor," say the researchers. "Dimeticone should be available to treat patients at an early stage of the disease in order to avoid life-threatening sequelae."
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