Name of the Condition

• Tungiasis [sand flea infestation]

Summary

• Tungiasis is a parasitic skin infestation caused by the female sand flea, Tunga penetrans. These fleas burrow into the skin, typically around the feet and toes, where they cause irritation and infection.

Causes

• Tungiasis is caused by the penetration of the female sand flea into the skin. The flea lives in sandy environments, often in warm and dry regions.

Risk Factors

• Living in or traveling to endemic regions, particularly coastal or semi-arid areas in Africa, Central and South America, and the Caribbean.
• Walking barefoot or wearing open footwear in sandy, infested environments.

Symptoms

• Intense itching and irritation at the site of infestation.
• Black dot at the center of a swollen, white lesion.
• Pain and discomfort in the affected area.
• Possible secondary infections due to scratching or bacteria.

Diagnosis

• Clinical examination revealing characteristic skin lesions.
• Identification of the flea within the lesion by a trained healthcare professional.

Treatment Options

• Physical removal of the flea using sterile instruments.
• Application of topical antibiotics to prevent secondary infection.
• In some cases, oral antibiotics may be prescribed if an infection develops.

Prognosis and Follow-Up

• With prompt treatment, the prognosis is generally good, and the infestation can be effectively cleared.
• Regular follow-ups may be required to monitor for secondary infections or re-infestations, especially in endemic areas.

Complications

• Secondary bacterial infections due to scratching.
• Formation of painful ulcers or abscesses.
• Chronic infestations can lead to deformity or loss of toenails.

Lifestyle & Prevention

• Wear closed shoes to avoid exposure to infested sands.
• Regularly inspect and clean feet and shoes after visiting potentially infested areas.
• Educate communities about the risks and preventive measures in endemic regions.

When to Seek Professional Help

• Persistent or severe itching at the site of exposure.
• Signs of infection such as redness, swelling, or pus.
• If a characteristic lesion persists or more lesions appear.

Additional Resources

• World Health Organization (WHO): Neglected Tropical Diseases
• Centers for Disease Control and Prevention (CDC): Parasites - Tungiasis

Tips for Medical Coders

• Ensure to use the correct ICD code B88.1 for tungiasis.
• Pay close attention to documentation details, particularly in cases involving complications or regions of exposure.
• Avoid confusing tungiasis with other flea-based conditions, ensuring proper coding for this specific infestation.