Insects and Infestations

Question 1

Bedbugs

Answer 1

• All life stages feed on blood
• Live in dark cracks and crevices in the vicinity of where people sleep or sit
• Inject anesthetic and anticoagulant

Question 2

Bedbug treatment

Answer 2

• washing at 60 C
• drying >40 C for 30 minutes
• freezing -17 C for 2 hours
• low or medium potency topical steroid
• systemic antihistamine

Question 3

Treatment for head lice

Answer 3

• Permethrin 1% and Pyrethrins & piperonyl butoxide
  
  • Ages >= 2
  • Leave on hair for 10 minutes, then rinse; repeat on day 9 (do twice)
• Lindane (organochlorine insecticide applied topically)
  
  • Should be a second line therapy in those who cannot tolerate or have failed other therapies for lice
• Bactrim (oral) + permethrin (topical)
  
  • for resistant cases

Question 4

Body lice (pediculosis corporis)

Answer 4

-Allergy to saliva in louse bite

Question 5

Pubic lice (Phthirus pubis)

Answer 5

• Can be asymptomatic but if symptomatic will have urticaria or maculae ceruleae
• Ciliaris (reddish, crusting, matting, usually bilateral and may involve eyebrow)

Question 6

Pubis treatment

Answer 6

-Topical permethrin 1% or pyrethrins + piperonly butoxide

Question 7

Ciliaris treatment

Answer 7

-Manual removal or apply ophthalmic grade vaseline

Question 8

Scabies

Answer 8

• Diagnosed by finding mites or burrows
• No OTC treatment
• Permethrin 5% cream kills mites and eggs
• Not safe for breast feeding
• For itching use antihistamines for up to 2 weeks or medium potency steroids

Question 9

Ticks

Answer 9

Feed on blood of humans and animals

-Takes 36 hours to transmit lime diseaseq

Question 10

DEET

Answer 10

• Topical N,N-diethyl-m-toluamide

- most effective repellant

Question 11

Stings

Answer 11

• Removal of stinger and apply ice promptly alternating 10 minutes
• OTC meds: Pramoxine, benzyl alcohol, dibucaine, topical diphenhydramine, hydrocortisone
• Diphenhydramine po 25-50 mg