Severe iron deficiency associated with head lice in young woman

A young patient with severe iron deficiency may have developed the condition from chronic and heavy lice infestation, according to an article published in BMJ Case Reports.

Although no definite relationship has been proved between head lice infestation and iron deficiency, several case reports have reported iron deficiency in patients with heavy lice infestation in the absence of other causes.

The young patient, a 23-year-old woman, was admitted to the emergency department with chest discomfort, palpitation, light-headedness and general fatigue. Blood tests revealed severe iron deficiency with a very low haemoglobin level of 2.2 g/L.

Her medical history and laboratory investigation did not show any obvious condition as the underlying cause of her anaemia, for example, she was not malnourished, and her albumin level was normal. She had secondary amenorrhoea, that is the absence of normal periods. A physical examination revealed heavy and chronic head lice infestation, and scratch marks on her scalp.

The doctors note previous case reports of severe iron deficiency in patients who were homeless, with limited access to hygiene, which led to with chronic and heavy lice infestation. The present patient had poor hygiene due to depression.

Doctors gave the patient two units of packed red blood cells, and her haemoglobin level increased. She was provided with insect repellent, head lice shampoo and intravenous iron therapy for anaemia. She was discharged with oral iron and folic supplementation.