Bugs & Bites Flashcards
What is Scabies?
Where is it m/c located?
- An intensely pruritic, contagious disease caused by Sarcoptes scabei transmitted by direct contact
- M/C in web spaces, body folds, wrists, between fingers & toes
Itch that’s worse at night, other family members have similar sx
Scabies
What skin manifestations are seen with Scabies?
- “Burrows”
- 1-2mm pustules (infants)
- Nodules/papules –> nodules on scrotum = scabies until proven otherwise!
- Eczematous reaction pattern with excoriation
What labs should you order for Scabies?
- Skin Biopsy
- Mineral oil/KOH
How do you treat Scabies?
- Permetherin topical cream
- Wash sheets in hot water
- Ivermectin
- Precipitated sulfur 6% if <2 mo old
Head lice is m/c in?
Body lice is associated with?
Pubic lice is also known as?
- School-age kids
- Poor hygiene
- “Crabs” (STD)
What skin findings to you see with lice?
- Live lice
- Pruritic papules
- “White dots” (nits) on hair shaft
How is lice treated?
- Permetherin rinse (NIX/Elimite)
- Ivermectin
- Lindane
- Shaving to remove nits
Linear distribution of bites
Bed Bugs
How do you treat bed bugs?
- Topical steroids
- Antihistamines
- Extermination
What’s the causative agent for Rocky Mountain Spotted Fever (RMSF)?
Rickettsia ricketsii
RMSF is characterized by acute onset of?
- Fever
- Severe H/A
- Myalgia
- Vomiting
- Petechial rash (day 3-5, but not all develop a rash)
What skin manifestations are seen with RMSF?
What’s the distribution?
- Discrete pink/purple macules that BLANCH with pressure then becomes petechial
- Diffuse vasculitis
- Starts on wrists & ankles –> palms/soles –> generalized
Complication of RMSF rash?
Post-inflammatory hyperpigmentation
T/F Labs are helpful for RMSF?
FALSE they’re rarely helpful
How is RMSF treated?
Doxycycline
What’s the causative agent for Lyme Disease?
What’s the vector/carrier?
- Borrelia Burgdorferi (spirochete)
- Ixodes scapularis (deer tick)
When is Lyme Disease m/c?
Late spring early summer (endemic in NE & MW)
When are sx typically seen with Lyme Disease?
3-21 days after bite
What are S&S of Lyme Disease?
- Erythema migrans (round expanding target rash that blanches)
- Fever/Malaise
- H/A, Neck stiffness
- Mylagia/Arthralgia
- Cardiac complications
How do you treat Lyme Disease?
Doxy or Amoxicillin
What do you see with a Brown Recluse Spider bite?
Rash starts as painless red papules/plaques that develop central pallor (can get necrosis, toxin destroys tissue)
How do you treat a Brown Recluse bite?
Supportive care (rest, ice, analgesic):
- Local wound care
- Abx/tetanus
- Oral steroids
- Hyperbaric chamber w/i 24 hrs to prevent necrosis
