{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T22:24:03Z","timestamp":1757456643680,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"GlaxoSmithKline R&D"},{"name":"GSK Africa Non-Communicable Disease Open Lab"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Tungiasis is a parasitic disease resulting from infestation by a female flea Tunga penetrans. The parasites are endemic in the tropics and can infect patients with diabetes mellitus (DM). Augmented by uncontrolled hyperglycemia and pre-existing neuropathy, the parasite may trigger a locally spreading inflammation, which may aggravate the trauma introduced during its extraction, leading into a rapidly progressing foot ulcer. To the best of our knowledge, no such cases in patients with type 2 diabetes have ever been published from Tanzania and likely none worldwide. This case report shows that, in diabetic patients, the wound resulting from the extraction of T. penetrans may get infected and aggravated by the ongoing inflammatory reaction, rapidly evolve into limb-threatening condition and mortality. Preventive measures are necessary and should be emphasized in patients with DM. Studies are needed to increase our understanding of the pathophysiology, proper management and sequalae of ulcers of this nature.<\/jats:p>","DOI":"10.1093\/omcr\/omac016","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T11:33:10Z","timestamp":1647603190000},"source":"Crossref","is-referenced-by-count":3,"title":["<i>Tunga penetrans<\/i> causing a rapidly progressing foot ulcer in a patient with uncontrolled type 2 diabetes mellitus"],"prefix":"10.1093","volume":"2022","author":[{"given":"Ashabilan A","family":"Ebrahim","sequence":"first","affiliation":[{"name":"Department of Physiology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisia P","family":"Mpango","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amana Regional Hospital, Dar es Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A","family":"Temba","sequence":"additional","affiliation":[{"name":"Department of Physiology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zulfiqarali G","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Abbas Medical Centre (AMC), Dar es Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5306-6703","authenticated-orcid":false,"given":"Fredirick L","family":"Mashili","sequence":"additional","affiliation":[{"name":"Department of Physiology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,3,16]]},"reference":[{"key":"2022031811295464800_ref1","article-title":"Tungiasis\u2014a neglected disease with many challenges for global public health","volume":"8","author":"","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"2022031811295464800_ref2","first-page":"636","article-title":"Tungiasis in North America","volume":"25","author":"Brothers","year":"1980","journal-title":"Cutis"},{"key":"2022031811295464800_ref3","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1053\/j.semvascsurg.2019.02.001","article-title":"The diabetic foot: pathophysiology, evaluation, and treatment","volume":"31","author":"Bandyk","year":"2018","journal-title":"Semin Vasc Surg"},{"key":"2022031811295464800_ref4","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.3855\/jidc.4324","article-title":"Tungiasis in northern Tanzania: a clinical report from Qameyu village, Babati District, Manyara Region","volume":"8","author":"Dassoni","year":"2014","journal-title":"J Infect Dev Ctries"},{"key":"2022031811295464800_ref5","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1111\/j.1365-4632.2007.03280.x","article-title":"Imported tungiasis: a report of 19 cases and review of the literature","volume":"46","author":"Veraldi","year":"2007","journal-title":"Int J Dermatol"},{"key":"2022031811295464800_ref6","doi-asserted-by":"crossref","first-page":"510","DOI":"10.2337\/diacare.26.2.510","article-title":"Quantifying the risk of infectious diseases for people with diabetes","volume":"26","author":"Shah","year":"2003","journal-title":"Diabetes Care"},{"key":"2022031811295464800_ref7","first-page":"510","article-title":"Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus","volume":"26","author":"Muller","year":"2005","journal-title":"Clin Infect 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