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Gilani M, Anthonappa R. Head lice-induced anemia in a child and implications for oral health: Case report. SPECIAL CARE IN DENTISTRY 2024; 44:761-767. [PMID: 37843406 DOI: 10.1111/scd.12933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/17/2023]
Abstract
Pediculosis capitis, colloquially referred to as head lice, engenders adverse social and economic consequences among children. While generally not considered a health hazard, chronic and severe head lice infestations have been linked to secondary iron-deficiency anemia. This case report documents a 7-year-old girl who presented for dental treatment with a history of social isolation and poor school attendance. Upon examination, the patient was found to have head lice and scabies infestations, resulting in secondary iron-deficiency anemia. The patient could return to full-time education after successful treatment for the head lice infestation administered by the dental team. This case underscores the need for treatment guidelines to manage children with diagnosed or suspected cases of head lice from a dental perspective. In instances of severe infestation, referral to a medical professional may be necessary for further management. This report highlights the importance of a multidisciplinary approach in managing head lice infestations and its implications on dental management.
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Affiliation(s)
- Maleeha Gilani
- Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Robert Anthonappa
- Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
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2
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Panagopoulou P, Ioannidou G, Beropouli S, Fotoulaki M. Head lice presenting with isolated severe eosinophilia in a child. Hippokratia 2023; 27:112-114. [PMID: 39119367 PMCID: PMC11305158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Background Eosinophilia is frequent in pediatrics and concerns regarding its etiology are often raised. Pediculosis capitis is a common ectoparasitic disease in children but is not traditionally associated with changes in laboratory parameters. Case description We present the case of a healthy, 9-year-old girl who presented with abdominal pain and a history of loose stools (2-3) in the preceding week. Laboratory investigations showed leukocytosis with significant eosinophilia. A thorough investigation concerning the most common causes of eosinophilia was negative. Detailed physical examination and history revealed a persistent scalp infestation with head lice. Successful pediculosis management coincided with the gradual resolution of eosinophilia without recurrence until the most recent follow-up visit twelve months later. Conclusions The presented case indicates a possible association between eosinophilia and pediculosis capitis, which was not previously displayed, but also highlights the importance of detailed history and clinical examination. Research focusing on the systematic effects of pediculosis capitis in children could clarify whether it can represent a frank cause of eosinophilia. HIPPOKRATIA 2023, 27 (2):112-114.
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Affiliation(s)
- P Panagopoulou
- 4Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - G Ioannidou
- 4Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - S Beropouli
- 1 Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - M Fotoulaki
- 4Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Greece
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3
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Perez M, Vinod B, Gandham S. More Than an Itch: An Unusual Cause of Severe Anemia in a 5-Year-Old. Clin Pediatr (Phila) 2022; 61:879-882. [PMID: 35746871 DOI: 10.1177/00099228221106630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michelle Perez
- Pediatric Resident Valley Children's Healthcare Pediatric Residency, Madera, CA, USA
| | - Balasa Vinod
- Hematology Valley Children's Healthcare, Madera, CA, USA
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4
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Mameledzija M, Nasrallah E, Hatrich M. Hypotension Unresponsive to Fluid Resuscitation: A Case Report. Clin Pract Cases Emerg Med 2022; 6:236-239. [PMID: 36049191 PMCID: PMC9436499 DOI: 10.5811/cpcem.2022.4.55896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/29/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Iron deficiency anemia is commonly seen in the emergency department (ED), and the cause can be complex and variable. Case Report We present a case of a female without known medical history who presented to the ED for generalized weakness and was found to have severe anemia in the setting of chronic lice infestation. Conclusion Severe and chronic pediculosis can cause chronic blood loss and be an unusual and rare cause of iron deficiency anemia. In the setting of anemia and hypotension unresponsive to fluid resuscitation, consideration should be given to early packed red blood cell transfusion and subsequent investigation of causes of severe anemia.
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Affiliation(s)
- Mahir Mameledzija
- University of Illinois at Chicago, Department of Emergency Medicine, Chicago, Illinois
| | - Erin Nasrallah
- Advocate Lutheran General Hospital, Department of Emergency Medicine, Park Ridge, Illinois
| | - Molly Hatrich
- University of Illinois at Chicago, Department of Emergency Medicine, Chicago, Illinois
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5
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Theroux Z, Hossler E. The nit sheath: a rare histopathologic clue for the diagnosis of louse infestation. J Cutan Pathol 2022; 49:929-930. [PMID: 35923069 DOI: 10.1111/cup.14301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/08/2022] [Accepted: 08/01/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Zachary Theroux
- Geisinger Medical Center, Dermatopathology Department, 100 N Academy Ave, Danville, PA
| | - Eric Hossler
- Geisinger Medical Center, Dermatopathology Department, 100 N Academy Ave, Danville, PA
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Ogbuji CO, Schuck A, DeVries M, Majdinasab EJ, Benson K, Zaid-Kaylani S, Bhaskaran S. Head Lice Infestation: An Unusual Cause of Iron Deficiency Anemia in a 13-Year-Old Female. Cureus 2022; 14:e25956. [PMID: 35855249 PMCID: PMC9284991 DOI: 10.7759/cureus.25956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
Pediculosis is a parasitic infestation of the human head and body by Pediculus humanus. This is a benign condition commonly seen in children and capable of causing severe pruritus. The parasite thrives on human blood and in some cases, the volume of blood loss over time could be large enough to precipitate anemic symptoms in the patient. We describe the case of a 13-year-old girl who presented with shortness of breath on exertion, palpitations, and easy fatigability. An incidental finding of Pediculus humanus capitis infestation was made during physical examination. Complete laboratory investigations did not reveal other possible causes of anemia, leading to a diagnosis of iron deficiency anemia (IDA) secondary to severe chronic pediculosis. This case highlights a rare and unusual cause of IDA in children caused by pediculosis, and the need for a thorough investigation, close follow-up, and treatment.
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7
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Rudd N, Zakaria A, Kohn MA, Amerson EH, Fox LP, Linos E, Chang AY. Association of Body Lice Infestation With Hemoglobin Values in Hospitalized Dermatology Patients. JAMA Dermatol 2022; 158:691-693. [PMID: 35442410 PMCID: PMC9021977 DOI: 10.1001/jamadermatol.2022.0818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Nora Rudd
- University of California San Francisco School of Medicine, San Francisco
| | - Adam Zakaria
- University of California San Francisco School of Medicine, San Francisco
| | - Michael A Kohn
- Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco
| | - Erin H Amerson
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California.,Department of Dermatology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California
| | - Lindy P Fox
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California
| | - Eleni Linos
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Aileen Y Chang
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California.,Department of Dermatology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California
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A 12-Year-old Girl With Chronic Pediculosis Infestation Presenting With Severe Iron Deficiency Anemia. J Pediatr Hematol Oncol 2022; 44:e804-e806. [PMID: 34486551 DOI: 10.1097/mph.0000000000002293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/01/2021] [Indexed: 11/26/2022]
Abstract
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.
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9
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Lowenstein EJ, Parish LC, Van Leer-Greenberg M, Hoenig LJ. The darker side of head lice infestations. Clin Dermatol 2022; 40:81-84. [PMID: 35190069 DOI: 10.1016/j.clindermatol.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Sheele JM, Libertin CR, Pritt BS, Wysokinska EM, Pietri JE. Investigating the association of bed bugs with infectious diseases: A retrospective case-control study. Heliyon 2021; 7:e08107. [PMID: 34765758 PMCID: PMC8569396 DOI: 10.1016/j.heliyon.2021.e08107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/19/2021] [Accepted: 09/28/2021] [Indexed: 11/27/2022] Open
Abstract
Bed bugs are common urban pests. Unlike many other blood-feeding human ectoparasites, bed bugs are not known to be vectors of human infectious diseases, but clinical and epidemiological studies to directly interrogate this link have been limited. Here, we aimed to determine whether bed bugs were associated with infectious diseases in a set of infested patients presenting to emergency departments (ED) in the greater Cleveland, OH area. We performed a retrospective case-control study involving 332 ED patients with bed bugs and 4,952 control patients, seen from February 1, 2011, through February 1, 2017. Cases and controls were matched by age, sex, and the presenting ED. Additionally, data were adjusted for ≥20 sociodemographic variables, triage data, and comorbidities in multivariable regression analyses. Seventeen laboratory values, ten different ED and inpatient diagnoses, chest radiographs, infectious disease consults, and blood cultures were examined. The odds of bed bug infestation were significantly higher for patients that had positive blood cultures, had blood cultures growing coagulase-negative Staphylococcus, were diagnosed with pneumonia, were diagnosed with cellulitis, received an infectious disease consult, received a chest radiograph, and had higher percentages of eosinophils in the blood (P < .05 for all). Additional investigations are needed to determine whether bed bugs directly contribute to disease by transmitting causative agents, whether bed bug exposure contributes secondarily contributes to infections, or whether these associations are better explained by other environmental and social determinants of health.
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Affiliation(s)
| | | | - Bobbi S. Pritt
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ewa M. Wysokinska
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Jose E. Pietri
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
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11
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Batool N, Song D, Reyes JVM, Ahmad S, Skulkidis A, Almas T, Khedro T, Brown M. Ectoparasitosis, a rare cause of severe iron deficiency anemia: A case report. Ann Med Surg (Lond) 2021; 69:102784. [PMID: 34527235 PMCID: PMC8430266 DOI: 10.1016/j.amsu.2021.102784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/23/2021] [Accepted: 09/02/2021] [Indexed: 11/08/2022] Open
Abstract
Pediculosis is a common condition caused by an infestation of head and body louse (ectoparasites) and remains a public health concern. Generally, infestation presents as pruritus in children and has a benign course, but there have been a handful of cases reported in the literature describing severe iron deficiency anemia (IDA) in high-risk groups such as children, history of psychiatric disorder including depression, and low socioeconomic status. Though an uncommonly encountered etiology of anemia, the aim of this case is to increase awareness of a rare cause of severe anemia from an ectoparasites affecting a high risk population, even in developed countries. Pediculosis is a common condition caused by an infestation of head and body louse (ectoparasites). Infestation can be asymptomatic, or involve tingling sensations of the skin, irritability, insomnia, and pruritus. In severe cases of infestation, it can, on a rare occasion, manifest as severe iron deficiency anemia. The clinical course can vary from benign skin infestation to severe debilitating anemia, but with use of pediculicide and hygiene maintenance the condition can be easily eradicated.
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Affiliation(s)
- Nuzhat Batool
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Hospital (Elmhurst Hospital Center), USA
| | - David Song
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Hospital (Elmhurst Hospital Center), USA
| | - Jonathan Vincent M Reyes
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Hospital (Elmhurst Hospital Center), USA
| | - Saad Ahmad
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Hospital (Elmhurst Hospital Center), USA
| | - Arigirios Skulkidis
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Hospital (Elmhurst Hospital Center), USA
| | - Talal Almas
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tarek Khedro
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Maritza Brown
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Hospital (Elmhurst Hospital Center), USA
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12
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Hersh AV, Wirkowski S, McMillon B, Balderston A, Hamelink A, McGowan K. A Case of Severe Iron Deficiency Anemia Due to Pediculus Capitis. CLINICAL PEDIATRIC HEMATOLOGY-ONCOLOGY 2021. [DOI: 10.15264/cpho.2021.28.1.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | | | | | | | - Alexis Hamelink
- Department of Pharmacy, Norton Children’s Hospital, Louisville, KY, USA
| | - Kerry McGowan
- Department of Pediatrics, University of Louisville, USA
- Department of Pediatrics, Norton Children’s Hospital, Louisville, KY, USA
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13
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Knapp AP, Rehmus W, Chang AY. Skin diseases in displaced populations: a review of contributing factors, challenges, and approaches to care. Int J Dermatol 2020; 59:1299-1311. [PMID: 32686140 DOI: 10.1111/ijd.15063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/11/2020] [Accepted: 06/19/2020] [Indexed: 01/14/2023]
Abstract
There are 70.8 million persons displaced worldwide due to war, persecution, and violence. Eighty percent of displaced persons reside in low- and middle-income countries with limited healthcare resources. Cutaneous diseases are commonly reported among displaced persons owing to numerous interrelated factors such as inadequate housing, overcrowding, food insecurity, environmental exposures, violence including torture, and breakdown of healthcare infrastructure. Diagnosis and management of these conditions, as well as an understanding of the context in which they present, is crucial to providing dermatologic care for displaced populations worldwide. Herein, we define displaced populations and, within this context, review the epidemiology of skin diseases, discuss pertinent skin conditions, examine challenges to care provision, and present approaches for improving dermatologic care. Inflammatory and communicable infectious disorders are the most common skin diseases seen in displaced populations. Other relevant conditions include skin manifestations of heat injuries, cold injuries, immersion foot syndromes, macronutrient and micronutrient deficiencies, torture, and sexual and gender-based violence. Provision of dermatologic care to displaced populations is hampered by limited diagnostic and therapeutic resources and specialist expertise. Medical screening for cutaneous disorders, context-relevant dermatology training, and telemedicine are potential tools to improve diagnosis and management of skin diseases in displaced populations.
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Affiliation(s)
- Alexia P Knapp
- Department of Dermatology, International Foundation for Dermatology Migrant Health Dermatology Working Group, HealthPartners Institute, Saint Paul, Minnesota, USA
| | - Wingfield Rehmus
- Departments of Pediatrics and Dermatology, University of British Columbia, Vancouver, BC, Canada
| | - Aileen Y Chang
- Department of Dermatology, International Foundation for Dermatology Migrant Health Dermatology Working Group, University of California, San Francisco, USA
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14
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Ectoparasites. J Am Acad Dermatol 2020; 82:551-569. [DOI: 10.1016/j.jaad.2019.05.110] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022]
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15
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Pietri JE, Yax JA, Agany DD, Gnimpieba EZ, Sheele JM. Body lice and bed bug co-infestation in an emergency department patient, Ohio, USA. IDCases 2020; 19:e00696. [PMID: 31988849 PMCID: PMC6970161 DOI: 10.1016/j.idcr.2020.e00696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 12/17/2022] Open
Abstract
Body lice and bed bugs are hematophagous insects that parasitize humans. Body lice are established vectors of several bacterial pathogens (e.g. Bartonella quintana, Borrelia recurrentis). Bed bugs are biologically competent vectors of some of the same agents, but their vectorial capacity for these in nature is unclear. In particular, a lack of exposure to louse-borne pathogens in bed bugs in the field could be a factor that limits their contribution to transmission. Here, we describe a case of a patient seen in an urban emergency department who was suffering from infestation with both body lice and bed bugs. Insects were collected from the patient and tested for the presence of louse-borne bacterial pathogens using 16S rRNA gene amplicon sequencing. Although no Bartonella, Borrelia, or Rickettsia were detected, this case provides evidence of ecological overlap between body lice and bed bugs and highlights several potential risk factors for co-infestation. The ecological relationships between bed bugs, body lice, and louse-borne bacteria should be further investigated in the field to determine the frequency of co-infestations and identify possible instances of pathogen infection in bed bugs.
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Affiliation(s)
- Jose E. Pietri
- University of South Dakota, Sanford School of Medicine, Division of Basic Biomedical Sciences, Vermillion, SD, United States
| | - Justin A. Yax
- University Hospitals Cleveland Medical Center, Division of Population Health, Department of Emergency Medicine, Cleveland, OH, United States
| | - Diing D.M. Agany
- University of South Dakota, Biomedical Engineering Program, Sioux Falls, SD, United States
| | - Etienne Z. Gnimpieba
- University of South Dakota, Biomedical Engineering Program, Sioux Falls, SD, United States
| | - Johnathan M. Sheele
- Mayo Clinic, Department of Emergency Medicine, Jacksonville, FL, United States
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