Pediculus humanus (body louse)

^[1]^[2]^[3]

Epidemiology

body lice remain in clothing except when feeding
unable to survive more than a few hours away from human hosts
affects largely disaster victims or indigent who do not change their clothing
body lice leave febrile persons or corpses as the become cold, thus facilitating transmission of epidemic typhus, trench fever & relapsing fever
transmissible infestation
transmission occurs by direct contact or sharing of clothing or bed & is enhanced in crowded conditions
females firmly cement their eggs to clothing
vector of epidemic typhus, trench fever & relapsing fever

pruritic lesions are especially common around the neckline
excoriations resulting in crusted papules or linear petechiae on trunk, neck, proximal arms
chronic infestations result in postinflammatory hyperpigmentation & thickening of skin known as vagabond disease

body louse infestation is a risk factor for endocarditis due to Baronella quintana^[3]

bathing
topical permethrin 1% or malathion 0.5% kills both lice & eggs
clothing & bedding are deloused by heat sterilization in a dryer at 65 degrees C for 30 minutes or by fumigation

↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1301
↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 935
↑ ^3.0 ^3.1 Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009