Head lice can be difficult to eradicate, especially in small children. A patient with an apparent treatment failure needs to be carefully evaluated to determine why the failure occurred so that corrective action can be taken.
|
Class of Problem |
Problem |
Response |
|---|---|---|
|
failure in diagnosis |
misdiagnosis of relapse |
Confirm diagnosis. |
|
|
psychogenic illness |
Evaluate for psychiatric issues. |
|
failure in instructions |
inappropriate instructions |
Give proper instructions. |
|
|
misunderstanding of instructions |
Help patient understand instructions |
|
failure to use |
high cost of products |
Give free samples or seek financial assistance. |
|
|
noncompliance |
Help the patient understand the need for treatment. Consider treatment under observation. |
|
inappropriate treatment |
inappropriate product |
Use correct product. |
|
|
inappropriate preparation |
Use correct preparation (shampoo, etc.). |
|
failure in following instructions |
failure to retreat |
Retreat properly. |
|
|
failure to remove live eggs |
Instruct in use of nit comb. |
|
|
insufficient dose-time, frequency and/or quantity of product applied |
Apply agent correctly. |
|
failure in prevention of re-exposure |
reinfestation from another person. |
Find source and treat both source and patient. |
|
|
reinfestation from source in environment. |
Instruct in how to eliminate lice and eggs in the clothing and environment. |
|
drug failure |
incomplete ovicidal activity |
Use agent with better ovicidal activity. |
|
|
acquired resistance to insecticide |
Test lice for drug resistance. |
Notes:
(1) misdiagnosis of persistent infection: Some parents find the diagnosis of head lice to be traumatic and afterwards become hypervigilant, mistaking dandruff or other innocuous findings as evidence of persistent infection.
(2) reinfestation from another person: Everyone in the environment needs to be treated simultaneously to prevent retransmission.
(3) reinfestation from source in the environment: Caps and bed linen need to be carefully cleaned to remove eggs and lice.
(4) Some people coating the hair with baby oil, provided that the hair is not too long.
Purpose: To identify causes of apparent treatment failure for a patient with head lice.
Specialty: Infectious Diseases, Pharmacology, clinical, Dermatology
Objective: failure handling and therapy escalation
ICD-10: B85.0,
