Infestations, Bites, and Stings

Lice Infestations in the Pediatric Population

“…Viable nits are also generally within a quarter inch from the scalp. To confirm viability, the nits can be viewed with microscopy at low power to determine if an intact operculum (cap) and a developing louse are within the egg (Paller & Mancini, 2016). In severe, long-term head lice infestation, laboratory findings may show iron deficiency anemia (Guss et al, 2011).…”

“…Depending on the type of lice infestation, treatment involves primarily deinfestation, either alone or in combination with topical pediculicide medications. Oral antihistamines may also be considered as adjunct therapy for pruritus (Paller & Mancini, 2016). Body lice are typically managed with deinfestation and improved hygiene with regular showering and bathing.…”

“…However, nonviable nits can remain on the hair for months. Manual nit removal is tedious and has only been shown to be beneficial if performed by professionals (Paller & Mancini, 2016; Williams et al, 2001). The American Academy of Pediatrics discourages “no-nit” policies as these policies did not decrease head-lice transmission (American Academy of Pediatrics, 2012) and led to unnecessary use of pediculicidal agents and missed school for children (Williams et al, 2001).…”

“…Lice infestation of humans is a common pruritic condition known as pediculosis. Pediculosis can often occur in the pediatric population and causes significant psychosocial distress and embarrassment (Paller & Mancini, 2016). The aim of this article is to provide a synopsis of the epidemiology and pathophysiology, diagnosis, management, and clinical pearls of the common pediatric dermatological condition of lice infestations.…”

“…The lice cling to clothing or hair near to the host's skin to feed on human blood and attach their transparent, flask-shaped 0.5-mm egg cases, called nits, to clothing seams or the hair shaft often 1-4 mm from the skin (Figure 1; Coates et al, 2020). Transmission for lice is primarily through direct contact, however, can also occur through contact with fomites (Paller & Mancini, 2016).…”