Flea (dog) infestation

[ericdamiansean]

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We have a case in the hospital, a 6 month old child presents with dog fleas/ticks which are crawling out of her nose, ear, mouth and anus. The docs are stumped, ENT, pediatrics, and finally the dermatologist. She asked me to find out what to give to her which would be able to kill the fleas, and I resorted to asking my vet friends, which they suggested medication (topical) creams which they use on dogs..I don't think this is right and it could be dangerous.

Anyone here knows what to do? Need urgent help.

So far, I've suggested to use petroleum jelly to suffocate the fleas, but they can only reach so far into the child's body orifices.

PS:I don't want to double post this in vet medicine

 

[EM Junkie]

After a quick search of PubMed, I found this article:

Estrada B. "Ectoparasitic infestations in homeless children." Semin Pediatr Infect Dis. 2003 Jan;14(1):20-4. PMID: 12748918

Sorry, I don't have online access to the full text version, but may be at your library.

Have you tried the meds used for lice infestation?
1% permethrin creme rinse X 10 min or
0.5% malathion x 8-12 hours or
Ivermectin
(taken from Harrison's "Ectoparasite infestation" chapter)

I think a call to Child Protective Services may be in order as well!

Good luck!

-Scott, MS3

 

[ericdamiansean]

Have you tried the meds used for lice infestation?
1% permethrin creme rinse X 10 min or
0.5% malathion x 8-12 hours or
Ivermectin
(taken from Harrison's "Ectoparasite infestation" chapter)

I think a call to Child Protective Services may be in order as well!

Good luck!

-Scott, MS3

Thanks, I did suggest permethrin cream...the pharmacy called to say that they do not have it 😱

 

[AF_PedsBoy]

I think a call to Child Protective Services may be in order as well!

Good luck!

-Scott, MS3

I agree - that severe an infestation doesn't seem like something that would happen acutely. On the other hand, never having had a problem with fleas, maybe they DO stampede en masse into a child's anus and various orifices...

 

[ForensicsBound]

Sucks to be on the peds rotation boy.

 

[bmcgilligan]

The active ingredients in Frontline (topical dog flea trt) are 9.8% fipronil and 8.8%(S)-methoprene.

I don't think applying a topical will do that good seeing that they have infested inside the body. Frontline and Advantage work by killing the fleas when they bite you.

Once fleas infest a dog or cat, Drontal or Droncit is given. I don't know what is in these pills, but it does the trick.


Oh, and fleas get to be that bad when a pt. ingests them or their eggs. I can see how this could be easy for a kid. If a pet has a flea infestation, the fleas lay eggs in the carpet, kid picks something up off the carpet, chews it, eats 'em, and gets really bad.

The major trt plan: De-flea the house, give all pets capstar and frontline and fix the kid.

 

[AF_PedsBoy]

Oh, and fleas get to be that bad when a pt. ingests them or their eggs. I can see how this could be easy for a kid. If a pet has a flea infestation, the fleas lay eggs in the carpet, kid picks something up off the carpet, chews it, eats 'em, and gets really bad.

Oh. That I didn't know! I still get the impression though that it would take a while before the ingested fleas or eggs germinate enough to produce the symptoms described... it seems kind of odd that the initial itching symptoms of the topical fleas didn't being the kid in sooner tho...