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Open Access Case report

Tungiasis presenting as a soft tissue oral lesion

Elizabeth Sentongo1* and Henry Wabinga2

Author Affiliations

1 Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences Makerere University, P. O. Box 7072, Kampala, Uganda

2 Department of Pathology, School of Biomedical Sciences, College of Health Sciences Makerere University, P. O. Box 7072, Kampala, Uganda

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BMC Oral Health 2014, 14:112  doi:10.1186/1472-6831-14-112

Published: 3 September 2014

Abstract

Background

The sand flea Tunga penetrans usually infects the feet and affects primary school-age children and elderly persons in rural Uganda. Tungiasis occurs nationwide but disease outbreaks have been reported in the Busoga sub-Region of eastern Uganda, associated with poor sanitation and proximity between humans and domestic animals. Ectopic tungiasis, usually seen with extensive infection and at weight-bearing body surfaces often follows exposure in highly infested environments. For patients who present abroad treatment may be surgical excision or amputation.

Case presentation

An adult female Musoga by tribe, resident in a Kampala City suburb presented at Mulago National Referral and Teaching Hospital’s Oral Surgery and Jaw Injuries Unit with a discoloured swollen tongue, facial cellulitis and submandibular lymphadenopathy. A swelling palpable in the body of her tongue was excised and sent for histology. Tungiasis of the tongue was diagnosed after microscopic examination of formalin-fixed paraffin-embedded Haematoxylin and Eosin-stained tissue sections.

Conclusion

Lingual tungiasis is a rare diagnosis that was made on histological examination. Atypical presentation outside an endemic area predisposed the patient to partial glossectomy instead of the less invasive flea enucleation. Ectopic disease in a city-resident highlights the plight not only of visitors to infested areas but also of the communities and their domestic animals.

Keywords:
Lingual ectopic tungiasis; Tunga penetrans; Histopathology; Uganda