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Tungiasis treatment — DTM&H MCQ

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HardDermatological Tropical ConditionsTungiasis treatmentDTM&H

A returned traveller has five viable periungual tungiasis lesions without bacterial cellulitis. Low-viscosity dimeticone is available, tetanus status is known and there is no neurovascular compromise. Which treatment best reflects current PAHO/WHO guidance?

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Correct answer: E — Apply low-viscosity dimeticone to each embedded flea using a targeted technique

The best answer is “Apply low-viscosity dimeticone to each embedded flea using a targeted technique”. Low-viscosity dimeticone is the evidence-based topical treatment now recommended for mild and severe tungiasis. Mechanical extraction is not the default when effective topical treatment is available; if extraction is chosen, trained staff should use surgical instruments under sterile conditions with wound care and tetanus review. Ivermectin and permethrin lack reliable efficacy against embedded Tunga, home needle extraction creates traumatic and infectious risk, and cryotherapy causes unnecessary tissue injury with possible retained inflammatory material.

Reference: WHO: Tungiasis fact sheet: https://www.who.int/news-room/fact-sheets/detail/tungiasis