Tungiasis Presenting as Onychomycosis: Probably the First Report of Flea Infestation of the Nail Observed Using Modified Potassium Hydroxide Mount Technique.

Venkataramana Kandi

doi:10.7759/cureus.2278

Abstract

Tungiasis is an infection/infestation of the flea Tunga penetrans. These are bloodsucking ectoparasitic insects belonging to the phylum Arthropoda, and they do not possess wings, but they have long legs enabling them to jump up to 30 cm high. The fleas are usually present on the skin and in the hair of domestic and wild animals and are prevalent throughout the world. They may also be present in an environment consisting of dry sandy soils, and they infect people who walk barefoot and reside in flea-infested areas. Human tungiasis is both an accidental and zoonotic infection, where the fleas enter the human skin and cause severe morbidity if not properly managed. There are a few reports of human tungiasis, most of which were diagnosed with skin infections. This is a first-of-its-kind observation of fleas in the nail, from a patient who is suspected to be suffering from onychomycosis. The nail in this case was processed differently, by using a modified potassium hydroxide (KOH) mount technique.

Highlights

Tungiasis is an infestation of the sand flea that belongs to the phylum Arthropoda, class Insecta, and order Siphonaptera
It is commonly referred to as chigoe flea, and Tunga penetrans (T penetrans) is its scientific name
Tungiasis is highly endemic to Trinidad and Tobago, Nigeria, and Brazil, where 50% people have been noted to be suffering from infections with T penetrans

Summary

Introduction

Tungiasis is an infestation of the sand flea that belongs to the phylum Arthropoda, class Insecta, and order Siphonaptera. How to cite this article Kandi V (March 05, 2018) Tungiasis Presenting as Onychomycosis: Probably the First Report of Flea Infestation of the Nail Observed Using Modified Potassium Hydroxide Mount Technique. Patients usually present to the dermatology department with infections/conditions of the skin, hair, and nails Most of these lesions are attributed to infection with microorganisms, including bacteria, viruses, fungi, and occasionally parasites. Technical modifications during the preparation and processing of specimens could increase the chances of finding the parasites [11] This is a report of a 45-year-old female patient, who presented to the dermatology outpatient department (OPD), with complaints of discoloration of nails (disfiguring and blackening), involving both the hands and the toe nails for three months. This procedure reduces the time of dissolving of the nail, does not destroy the microorganisms or parasites present in the specimen, and could be effective in demonstrating the parasites, if any, present in the nail

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Disclosures