A 12-Year-old Girl With Chronic Pediculosis Infestation Presenting With Severe Iron Deficiency Anemia.

Iron deficiency is the leading etiology of anemia worldwide. Excessive cow's milk intake and menorrhagia are the most common etiologies in the pediatric population in the United States, with parasitic infections a more common cause in lower-resource countries. Here we present a case of a 12-year-old female in the midwestern United States with severe iron deficiency anemia (hemoglobin 4.7 g/dL) and chronic pediculosis infestation. Anemia resolved with transfusion, iron supplementation, and eradication of the parasite. We believe this is the only reported case of a child in the United States with severe iron deficiency anemia secondary to chronic severe lice infestation.

Treatment of Scabies and Pediculosis in Health Education Publications and Folk Medicine of Eastern Croatia - Slavonija, Baranja, and Western Srijem County.

Scabies and pediculosis are common parasitic infestations of the skin and hair, manifesting with intense pruritus and effectively treated with modern medications. Because of the attached social stigma linking it with poverty and poor hygiene, patients will often attempt alternative folk-based remedies before confiding in their physicians. We conducted a comprehensive bibliographical study of historic folk literature and interviewed 70 individuals experienced in everyday application of folk medicine in order to categorize available remedies and provide a modern, scientific comment on their effectiveness and dangers. Compositions containing sulfur, copper sulfate, petroleum, coal, tar, and highly alkaline soaps and washing solutions undoubtedly have scabicidal and pediculicidal properties, but they are used either in high concentrations with greater possibility of intoxication and irritation or lower concentrations with questionable therapeutic benefit. These remedies, extracted from historical-cultural frameworks, are poorly adapted to modern standards and can lead to side-effects and complications. Physicians today have to be aware of the reasons their patients seek alternative remedies and know the substances and procedures they may use in self-healing, so as to be able to provide the help that may be needed if those complications occur.

Management of Head Louse Infestations in the United States-A Literature Review.

UNLABELLED: Head lice are a source of scalp irritation, social disruption, and loss of school time. Health care providers need authoritative information to help avoid the costs and risks of ineffective treatment. A review was completed to provide relevant information on infestation treatments available in the United States. Three major biomedical databases were searched from 1985, when current products were first available, to 2014, focusing on U.S. REPORTS: A total of 579 references remained after duplicates were removed. A search of the U.S. Food and Drug Administration website and labels of approved products were reviewed. A marked decline in the effectiveness of permethrin and synergized pyrethrins was found, probably because of resistance arising from widespread and indiscriminate use, and the emergence of knockdown resistance mutations. The potential toxicity of lindane in the setting of readily available, safer, and more effective alternatives, should limit its use. Prescription products shown to be safe and effective with a single application, without nit combing, are topical ivermectin, malathion, and spinosad, whereas benzyl alcohol requires two applications. Home remedies such as mayonnaise, and essential oils, have not been demonstrated to be safe or effective, and may carry potential for severe adverse events. The high risk of failure of over-the-counter treatments in eliminating head louse infestations drives a need for health care provider recognition of the limitations of current treatments and for judicious use of treatments that remain effective.

[Management of lice infestations, recommendations for 2012]. / Prise en charge des pédiculoses en 2012.

Pediculosis is the most frequent and contagious ectoparasitic infestation in human, particularly in children from 3 to 8 years of age. Epidemics are observed from time to time, in schools or in adults in prisons. Even though benign, these infections remain unpleasant and can have an important psyco-social impact. Since a few years, caregivers have to face increasing problems while treating lice: appearance of insecticide resistances, lindane's withdrawal from the market and the marketing of new products which are not always well evaluated. This article offers first recalls about pediculoses and then a sum up of the different available treatments with an evidence based management strategy.

Head lice.

BACKGROUND: Head lice infestation is a very common problem in children and causes a high level of anxiety among parents and childcare workers. OBJECTIVE: In this article we attempt to clarify issues of diagnosis and treatment of head lice and offer recommendations for dealing with head lice. DISCUSSION: Head lice are a nuisance, but they do not transmit infectious diseases. Control includes detection with wet comb technique. Treatment is usually with a topical pediculicide, but regular mechanical removal with conditioner and a comb is an alternative. Treatment failure can be the result of inadequate application of the treating product, pediculicide resistance, or failure to re-treat at 7-10 days. Reinfestation (and therefore apparent treatment failure) is common.

The in vivo pediculicidal efficacy of a natural remedy.

BACKGROUND: Head louse infestations are prevalent worldwide. Over the past 20-25 years, 15-20% of all children in Israel between 4 and 13 years of age have been infested with head lice. This is mainly due to the existence of ineffective pediculicides on the market. OBJECTIVE: To examine the pediculicidal efficacy and safety of a natural remedy ("Chick-Chack") and to compare it in an open clinical study with a known pesticide spray. METHODS: The natural remedy, which contains coconut oil, anise oil and ylang ylang oil, was applied to the hair of infested children three times at 5 day intervals. Each treatment lasted for 15 minutes. The control pediculicide was a spray formulation containing permethrin, malathion, piperonyl butoxide, isododecane and propellant gas, which was applied twice for 10 minutes with a 10 day interval between applications. RESULTS: Of 940 children, aged 6-14 years, from six schools in Jerusalem who were examined for head louse infestation, 199 (21.2%) were infested with lice and eggs, while 164 (17.4%) were infested only with nits. Altogether, 119 children were randomly treated with either the natural remedy or the control product. Treatment was successful with the natural remedy in 60 children (92.3%) and with the control pediculicide in 59 children (92.2%). There were no significant side effects associated with either formulation. CONCLUSIONS: The natural remedy was very effective in controlling louse infestations under clinical conditions and caused no serious side effects.

Head lice for A & E nurses.

Accident and emergency nurses are in an excellent position to offer skill and advice on the treatment of head lice, from health education to diagnosis and cure to contact tracing. This paper offers guidance on how to detect lice and how to treat infestation. There are a number of treatment options available, including pharmacological and physical treatments. Choosing the most appropriate option can be difficult due to reports of 'Super Nits' resistant to insecticides and lack of data to support the use of alternative methods such as 'wet combing' and aromatherapy treatments. However, nurses do need to be aware of how lice move between people, so they can take an active role in health education and make sure that patients affected by head lice are managed properly.

Prevention and treatment of head lice in children.

Head louse infestations (pediculosis) are prevalent worldwide. In developed countries, the infestation rate of 4- to 13-year-old children remains high despite preventive efforts. This is due to the existence of numerous ineffective pediculicides, the incorrect use of the effective agents, toxicological concerns and the development of louse strains resistant to insecticides. One of the most effective tools for the prevention and control of lice is the louse comb, which should be used regularly for the detection of living lice at an early stage of infestation, and as an accessory to any treatment method to remove living and dead lice. The louse comb can also be used systematically for the treatment of infestations, for confirmation that treatment with pediculicides has been successful, and for the removal of nits (dead eggs or egg shells). Most pediculicides are only partially ovicidal. Therefore, 10 days after beginning treatment with any antilouse product, the scalp of the child should be examined. If no living lice are found, the treatment should be discontinued. If living lice are still present, treatment should be continued with a product containing a different active ingredient. Suffocating agents such as olive, soya, sunflower and corn oils, hair gels and mayonnaise are able to kill a significant number of lice only if they are applied in liberal quantities for more than 12 hours. However, they lubricate the hair and therefore may facilitate combing and removing lice and eggs from the scalp. Nits may remain glued on the hair for at least 6 months, even after a successful treatment, and lead to a false positive diagnosis of louse infestation. If nits are seen on the hair, the child should be examined, but treatment should be initiated only if living lice are found. Formulations containing 5% acetic acid or 8% formic acid, as well as acid shampoos (pH 4.5 to 5.5) and conditioners, in combination with a louse comb, can be helpful for removing nits. There is no conclusive evidence that using essential oils to repel lice is effective. Regular examination of the child's head using a louse comb is the best measure to detect re-infestation at an early stage. Educating caregivers, nurses and teachers about louse biology, epidemiology, prevention and control is of paramount importance. The psychological effect of an infestation with lice is significant and often associated with anxiety and fear. The child should not be made to feel responsible for having lice, or be punished or reprimanded.

Diagnosing and treating Phthirus pubis palpebrarum.

Phthiriasis palpebrarum is an uncommon cause of blepharitis and conjunctivitis and may easily be overlooked. A high index of suspicion and careful examination of the patient's lid margins and eyelashes will lead to the proper diagnosis. Treatment is best accomplished by careful removal of the lice and nits (louse eggs) from the patient's lashes. Local application of a pediculocide such as yellow mercuric oxide N.F. 1% ophthalmic ointment applied twice daily for one week or 0.25% physostigmine (Eserine) ointment applied twice daily for a minimum of ten days, to the lid margins should be considered when the total removal of Phthirus pubis and nits is not possible mechanically. Body hair should be examined for infestation with lice and treated with gamma benzene hexachloride shampoo. This medication should be used with caution in infants, children and pregnant women. Family members, sexual contacts, and close companions should be examined and treated appropriately; clothing, linen and personal items should be disinfected with heat of 50 degrees C for 30 minutes.