Fast Five Quiz: Test Yourself on Clinical Information About Insect Bites

Richard H. Sinert, DO


June 16, 2017

Infestation with P pubis is a sexually transmitted disease, and 30% of these patients have an additional STD. Thus, it is appropriate to screen these patients for other sexually transmitted diseases, including HIV, syphilis, gonorrhea, chlamydia, genital herpes, and trichomoniasis.

Because the diagnosis of infestation requires identification of a live louse and/or a viable nit, examining suggestive particles under the microscope confirms the diagnosis. Cellulose tape can be applied over an infested area to pick up lice and place them on a microscopic slide to be examined. Scrapings for a fungal culture can be collected if dermatophyte infection is in the differential diagnoses. This is useful when the diagnosis is unclear (ie, no nits or lice have been identified). Histology is rarely required for diagnosis. Examination of a bite shows intradermal hemorrhage and a deep, wedge-shaped infiltrate with many eosinophils and lymphocytes.

For more on the workup of pediculosis, read here.


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