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Microbiology · Ectoparasites

Tunga penetrans !

  • Parasite
  • For completeness

A sand flea that burrows into the skin of bare feet, usually beside the toenails, and swells into a small lump with a black dot.

Updated 2026-11-01

Also called: chigoe flea, jigger, sand flea

At a glance

Shape
Whitish nodule with a central black dot (the flea's rear end)
Family
Tungidae
Type
Insect: flea (Siphonaptera), ectoparasite
Size
Flea about 1 mm; the gravid female grows to about 1 cm in the skin

Morphology

  • Only the fertilised female penetrates the skin.
  • It leaves its rear end exposed to breathe, defecate and expel eggs.
  • Its abdomen swells enormously inside the epidermis.

Transmission

  • Walking barefoot on sandy or earthen ground where the larvae develop.
  • Earthen floors in homes and animal pens.
  • Not spread from person to person.

Reservoir: Pigs and cattle in rural areas; Dogs, cats and rats in poor urban neighbourhoods; Sandy or earthen soil

Isolation precautions

What the care team adds to standard precautions.

  • Standard

Life cycle

  1. The fertilised female penetrates the skin, usually between the toes or under the toenails.
  2. It anchors head-down and leaves its rear end exposed to breathe and expel eggs.
  3. Its abdomen grows to about 1 cm and expels about 100 eggs over two weeks; then it dies.
  4. In sandy soil the eggs hatch in 3–4 days; the larvae feed on organic debris.
  5. After two larval stages they pupate in sand-covered cocoons; development takes 3–4 weeks.
  6. Adults emerge and seek a warm-blooded host: person, pig, dog, cat or rat.

Virulence factors

  • The embedded flea causes intense inflammation, pain and itch.
  • Lesions ulcerate and become infected; there is a risk of tetanus and gangrene.
  • Repeated infestation deforms toes, causes nail loss and makes walking hard.
  • Removal with non-sterile objects can spread infections.

Diseases it causes

Clinical picture

  • Whitish papule or nodule with a central black dot on the toes, nail folds or heel.
  • Pain and itch; difficulty walking.
  • Multiple infestations in children and older adults in poor communities.

Diagnosis

  • Clinical diagnosis from the typical lesion on the foot.
  • Finding the flea and its eggs in the lesion.

Treatment

Sterile extraction of the flea by trained staff, wound care and a tetanus check; topical dimeticone is an effective and safe treatment. Antibiotics for superinfection.

Drug class only; doses and regimens are set by the clinician from the current guideline.

Prevention

  • Wear closed shoes.
  • Seal or cement earthen floors and treat them with insecticide.
  • Daily foot washing with soap.
  • Treat infested animals (One Health).

Test yourself

Think of the answer, then tap the question to see it.

Where is tungiasis typically found?

On the feet, between the toes and under or beside the nails, from walking barefoot.

What does a Tunga penetrans lesion look like?

A whitish nodule with a central black dot, which is the flea's rear end.

Which serious infection must be prevented in tungiasis?

Tetanus, as well as bacterial superinfection.

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Educational content on microorganisms; not a treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: CDC - DPDx - Tungiasis (CDC, 2017); Tungiasis (WHO, 2023).

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Representative model, for educational purposes only.