Tungiasis presenting as a soft tissue oral lesion

Area of Science:

• Medical Entomology
• Parasitology
• Tropical Medicine

Background:

• Tunga penetrans, the sand flea, commonly infects feet, particularly affecting children and the elderly in rural Uganda.
• Tungiasis outbreaks are linked to poor sanitation and close human-animal proximity, especially in the Busoga sub-Region.
• Ectopic tungiasis, often extensive, occurs on weight-bearing surfaces after exposure in highly infested areas.

Observation:

• A woman residing in Kampala presented with a swollen tongue, facial cellulitis, and lymphadenopathy.
• A palpable swelling in her tongue was surgically excised for histological examination.
• Microscopic analysis of stained tissue sections confirmed tungiasis of the tongue.

Findings:

• Lingual tungiasis is an uncommon diagnosis, confirmed through histological examination.
• The patient underwent a partial glossectomy due to the atypical presentation outside an endemic area.
• Ectopic sand flea infestation in an urban setting highlights risks for residents and visitors.

Implications:

• This case underscores the importance of considering ectopic tungiasis in unusual presentations, even in urban settings.
• Early diagnosis and less invasive treatments like flea enucleation are preferred but may not be feasible for atypical cases.
• Public health initiatives addressing sanitation and human-animal interactions are crucial in controlling sand flea infestations.