26: Infestations Flashcards
1
Q
For head lice:
- Organism
- Epidemiology
- Transmission
- Clinical
- Diagnosis
- Treatment
A
- Pediculus humanus capitis; adult size of sesame seed, live up to 30 days
- Children, caretakers, females > males, white > black
- Head-to-head; fomites
- Most cases asymptomatic; itching, tickling, difficulty sleeping, sores (staph, GAS); cervical, nuchal lymphadenopathy, pyoderma
- Find live lice, nits (if within 1/4 inch of scalp but no live lice, assume present and treat)
- OTC: pyrethrins, permethrin; Rx: malathion, benzyl alcohol lotion, ivermectin, spinosad
2
Q
For crabs:
- Organism
- Epidemiology
- Transmission
- Clinical
- Diagnosis
- Treatment
A
- Phthirus pubis; broader and stubbier than head/body lice
- Teens and young adults
- Sexual, fomites
- Itchin, excoriations, pale bluish macules, lymphadenopathy, superimposed bacterial infx, live lice, nits
- Find live lice, history
- Permethrin (less allergy), pyrethrins (neurotoxic), malathion, ivermectin, lindane
3
Q
For bed bugs:
- Organism
- Epidemiology
- Transmission
- Clinical
- Diagnosis
- Treatment
A
- Cimex lectularius, hemipterus; small, reddish-brown insect; host not required
- Worldwide, more common in developing nations
- Easy
- Painful and/or itchy swellings, anaphylaxis, superficial bacterial infection
- exoskeleton, blood spots, sweet musty odor
- Exterminator
4
Q
For scabies:
- Organism
- Epidemiology
- Transmission
- Clinical
- Diagnosis
- Treatment
A
- Sarcoptes sabiei (microscopic); live and burrow into stratum corneum
- All social classes
- Close contact (sexual transmission, parent-children)
- 2-3 weeks after infection; intense itching (worse at night) possibly grayish serpentine lines, pimple-like rash on sides & webs of fingers/toes, wrists & groin; secondary bacterial infx not uncommon
- Lesions & distribution; skin scrapings, adhesive tape test, demoscopy
- Permethrin, oral ivermectin (not in pregnancy)
5
Q
What is Crusted (Norwegian) Scabies?
A
- Cellular immunity compromised
- Entire body involved; crusts and scales, warty lesions
- Malodor, bacterial infection
- Hundreds to millions of mites
- Highly contagious, fomites major problem
