Case Report: Evidence of Tungiasis in the Amazon Rain Forest of Ecuador.

Tungiasis occurs in tropical and subtropical areas in Central and South America and sub-Saharan Africa and is a Neglected Tropical Disease. We diagnosed three cases of tungiasis in a Dutch family visiting indigenous communities in the Amazon basin of Ecuador. Eight days after returning, they presented papular, pruritic, and painful lesions on the feet, with a whitish halo and a blackish central point with abundant whitish eggs upon extraction. For the first time, we demonstrate that Tunga spp. transmission is present in remote indigenous communities in the Amazon rainforest of Ecuador. It will be important to investigate the occurrence of tungiasis and associated morbidity among local inhabitants and consider prevention measures among locals and travelers to these areas.