Case #328 – July, 2012

A 25-year-old woman traveled to Kenya and Uganda for three months of field work in public health entomology. Upon returning to the United States, she noticed a painful lesion on her left big toe, just at the intersection with the nail (Figure A). She visited her primary care physician. While applying pressure to the region during examination, eggs appeared to exude from the lesion (Figure B). Eggs were sent to Microbiology for diagnostic assistance. The eggs measured on average 600 micrometers in length. What is your diagnosis? Based on what criteria?

This case and images were kindly provided by the USDA, Manhattan, KS.

Images presented in the DPDx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.