Endgames Spot Diagnosis

A Brazilian child with a nodule in the foot

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2396 (Published 09 June 2017) Cite this as: BMJ 2017;357:j2396
  1. Khuen Foong Ng, paediatric infectious diseases and immunology fellow,
  2. Stephen Owens, paediatric infectious diseases and immunology consultant
  1. Great North Children’s Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Khuen Foong Ng khuenfoong.ng{at}doctors.org.uk

A 2 year old girl from the north coast of Brazil presented on arrival in the UK with a day’s history of a painful and mildly pruritic nodule on the sole of her right foot. Seven days later, the nodule had grown in size and had become more tender (fig 1). What is the diagnosis?

Fig 1 7×7 mm skin nodule on the plantar surface of right foot with central black mark

Answer

Short answer

Tungiasis, a cutaneous ectoparasitic infection caused by female Tunga penetrans, also called jigger, nigua, chica, pico, …

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