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Pediculosis, Emergency Medicine

Reviewed 06/2017



  • Infestation by organisms that live in close association with host

  • Bites are painless

  • Signs and symptoms result from host response to saliva and anticoagulant injected during feeding

  • Tra...


Signs and Symptoms


  • Head lice:

    • Dandruff

    • Pruritus

    • Often asymptomatic

  • Body lice:

    • Pruritus

    • Excoriation particularly at belt lines or seams of clothing

  • Pubic lice:

    • Intense pruritus, worse at night

Physical Exam



Maintain universal precautions 

Initial Stabilization/Therapy

Not applicable for routine cases 

Ed Treatment/Procedures

  • Oral antihistamines and topical steroids may help pruritic sym...



Admission Criteria

Extensive bacterial superinfection; systemic hypersensitivity reaction with cardiorespiratory compromise 

Discharge Criteria

  • Mild-to-moderate infestation with abse...

Pearls and Pitfalls

  • Diagnosed by direct visualization

  • Most of the topical agents need to be reapplied in 7–10 days because unhatched eggs are not killed

  • Clothing and bedding must be washed and dried at ...

Additional Reading

  • Benzyl alcohol lotion for head lice. Med Lett Drugs Ther.  2009;51:57.

  • Chosidow  O, Giraudeau  B. Topical ivermectin – a step toward making head lice dead lice? N Engl J Med. &#...



  • 132.0 Pediculus capitis [head louse]

  • 132.1 Pediculus corporis [body louse]

  • 132.9 Pediculosis, unspecified

  • 132.2 Phthirus pubis [pubic louse]

  • 132.3 Mixed pediculosis infestation

  • 132 Pediculosis an...

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