Abstract
Background
Lice infestation is a commonly encountered disorder in emergency medicine. The louse
survives from a blood meal from its host; hence, iron deficiency anemia is a theoretic
possibility. A limited number of reports of severe iron deficiency anemia have appeared
in the veterinary literature, but a thorough review of the medical literature did
not reveal a single instance in human beings.
Objective
We report a small case series of patients with heavy louse infestation and profound
iron deficiency anemia.
Case report
The index case along with two other cases discovered from an exhaustive search of
4 years of the institution’s Emergency Department records all had heavy infestation
with head and body lice. Laboratory evaluation revealed serum hemoglobin levels under
6 gm/dL, low serum ferritin levels, and microcytic red blood cell indices. All patients
were admitted to the hospital, received transfusions, and had evaluation of their
anemia. No patient had evidence of gastrointestinal blood loss or alternative explanation
for their anemia.
Conclusions
Although cause and effect cannot be established from this case series, to the best
of our knowledge, this is the first published evidence of a provocative association
of louse infestation and severe iron deficiency anemia in humans.
Keywords
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Article info
Publication history
Published online: July 26, 2010
Accepted:
May 18,
2010
Received in revised form:
April 7,
2010
Received:
February 2,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
