A nurse is checking a school-age child for pediculosis capitis. Which of the following findings is a definitive indication of this condition?
A.
Firmly attached white particles on the hair
B.
Itching and scratching of the head
C.
Thick, yellow-crusted lesions on a red base
D.
Patchy areas of hair loss
The Correct answer and Explanation is:
The correct answer is:
A. Firmly attached white particles on the hair
Explanation:
Pediculosis capitis, commonly known as head lice infestation, is a condition caused by the infestation of the scalp by the head louse (Pediculus humanus capitis). The most definitive indication of this condition is the presence of nits (lice eggs) that are firmly attached to the hair shafts. These nits appear as tiny, oval-shaped, white or yellowish particles that are often mistaken for dandruff. However, unlike dandruff, nits are firmly glued to the hair and cannot be easily brushed off. They are typically found close to the scalp, where warmth and humidity are optimal for the development of the eggs.
Breakdown of the Options:
- Option A: Firmly attached white particles on the hair (Correct)
- This option is correct because it describes nits, which are the eggs of head lice. These particles are firmly attached to the hair near the scalp and are a definitive sign of pediculosis capitis. While adult lice and nymphs (immature lice) can also indicate infestation, they are often difficult to spot. The presence of nits is a clear indication that an infestation is present or was recently present.
- Option B: Itching and scratching of the head
- Although itching and scratching are common symptoms of head lice infestation, they are not definitive indications. Itching occurs due to an allergic reaction to louse saliva. However, other conditions, such as dandruff, eczema, or allergic reactions, can also cause itching, so this symptom alone cannot confirm pediculosis capitis.
- Option C: Thick, yellow-crusted lesions on a red base
- This option describes impetigo, a bacterial skin infection that often results from scratching due to various skin conditions, including lice infestation. While impetigo may be a secondary complication of pediculosis capitis, it is not a definitive sign of lice.
- Option D: Patchy areas of hair loss
- Patchy hair loss is not characteristic of pediculosis capitis. This finding is more commonly associated with conditions such as alopecia areata or fungal infections like tinea capitis.
Conclusion:
The key to diagnosing pediculosis capitis is identifying the presence of nits firmly attached to the hair. While other symptoms like itching are common, they are not specific to lice infestation. Accurate identification and prompt treatment are essential to managing and preventing the spread of head lice, especially in settings like schools where close contact facilitates transmission.