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 Reduvid bug  
| • | AKA assassin bug, kissing bug, cone-nosed bug         |  
 | • | large insects with distinct elongate cone-shaped heads |  
 | • | vectors for:   T. cruzi (Chagas disease) |  
 | • | transmits through defecation |  
 | • | Romania’s sign – periorbital swelling |  
   
  
  
Fleas 
| • | long legs (jumpers), no wings |  
 | • | therefore bite on lower legs |  
 | • | vector for – plague (bubonic), endemic (murine) typhus |  
   
jigger flea (Tunga penetrans) 
| • | AKA burrowing flea, chigoe |  
 | • | not to be confused with a “chigger” (a mite) |  
 | • | burrows into the skin of the toes or soles of feet; produces eggs and dies still embedded in the tissue |  
   
  
Flies 
MYIASIS 
| • | human bot fly (Dermatobia hominis) |  
 | • | females lay eggs on the abdomens of captured mosquitoes, who deposit the eggs on the skin of a warm-blooded host (e.g. humans) |  
   
Bartonella bacilliformis 
| • | two stages of the same infection: |  
 | • | Oroya fever – acute febrile stage |  
 | • | Verruga Peruana – chronic delayed stage |  
 | • | weeks to months after acute infection  |  
 | • | clinically and histologically the lesion are virtually identical to bacillary angiomatosis (but organisms stain with Giemsa in verruga peruana) |  
 | • | endemic to Peru (500-3200 meters above sea level in the Andes) |  
  
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