A 23-year-old man presented with a small black lesion at the distal margin of the right great toenail. He had returned from the Ivory Coast 1 month previously, having spent 6 weeks there. Histopathological examination of material extruded from the lesion showed a variety of arthropod internal organs, allowing a definitive diagnosis of infection with the ectoparasitic flea Tunga penetrans. Curettage of the lesion revealed a gravid adult female flea.
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Douglas-Jones et al. (2006) studied this question.
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