Threadworm & Scabies Flashcards
How are eggs transmitted?
faecal-oral transmission
What are clinical features of threadworm?
- Night-time perianal itching - caused from mucous produced by females when laying eggs
- Local tickling sensation to acute pain
- Eggs and worms may be visible and in the excrement after going to the toilet
- Intense perianal itching especially in the morning
When to refer pts suspected of threadworm?
- Recent abroad travel
- Failed treatment
- Children under 2 years
What OTC medication is given for threadworm?
Ovex - mebendazole
100mg as a single tablet or 5ml suspension
one dose is usually sufficient but can repeat after 2 weeks
Should tx be given to all family members for threadworm?
Yes as it is likely that other family members will have been infected
Can mebendazole be used in children?
only >2 years
What are the S/E of mebendazole?
Abdominal pain, rash, diarrhoea
What drugs can interact with mebenazole?
phenytoin, carbamazepine - decreases mebendazole plasma levels so the dose may need to be increased
Can mebendazole be given in BF or pregnancy?
no data so avoid BF
Avoid in P
What are hygiene measures the pt should take?
Keep nails short and clean
Careful washing and nail scrubbing before meals and after each visit to the toilet to prevent autoinfection
bed linen, towels and sleepwear should be washed on the first day of tx
Shower daily
What are scabies?
mites burrowed beneath the skin surface causing allergic reaction to their coat and exudates resulting in intense itching (prutius)
What are symptoms of scabies?
itching especially at night, appearance of the burrows are smalll thread-like grey lines, most visible in the webs of the fingers and toes
What questions may you ask a pt who may have scabies?
visible signs of mites?
Location of the rash? - finger webs and wrists
History of presenting complaint
Do all members of the household need to be treated for scabies?
yes and close contacts and clothes and bed linen should be washed at temperatures above 50 at time of tx
What tx preps are available OTC for scabies?
- Aqueous preps
- Permethrin (Lyclear cream) or Malathion products can be used, 2 tx are recommended 7 days apart
- Applications should be applied to the entire body and left on for 8-12 hours (for permethrin cream) or 24 hours before bathing (malathion lotion)
How long will the itch last for for scabies? What can you recommend for this?
2-3 weeks even after insecticide tx as the allergens still remain but symptoms will eventually fade. Crotamiton cream (Eurax) can be recommended
How are scabies transmitted?
By close contact with an infected individual so infected pts should be alerted to avoid contact with others.
How long may symptoms not show once a pt is infected with scabies?
up to 8 weeks after infestation
What are other counselling advice you can give for a person with scabies?
wash clothing and bedding at temperatures above 50 degrees
What children use permethrin, benzyl benzoate and malathion?
Permethrin - > 2 years
Benzyl B > 12 years
MAlathion > 6 months
What are the S/E that can occur with tx of scabies?
burning, stinging or tingling, irritation
How often is permethrin used?
The whole tube is used for adults and children over 12 as a single application
1/4 tube those 2months-5 years
1/2 tube those 6-12 years
wash the whole body thoroughly 8-12 hours after tx.
repeat after 7 days
How often should Malathion be used?
leave on for 24 hours - reapply to hands if washed
repeat after 7 days
