Scabies

[meeka720]

I have a student who we sent home who we suspected of having scabies. This poor child was itching all day. She was covered on her stomach, back, arms, armpits, hands and neck. Her mother called back later that day stating that the Dr. stated the spots were either infected hair follicles or flee bites. I have seen many cases of scabies all of which look just like this child. However I have never seen multiple infected hair follicles or flee bites covering a child in this manner, with many of the spots being in rows. The Dr. sent a note stating that this child could return to school. It has been 3 days and the teacher sent the student back down to the clinic today. The child was still itching and many of the old spots are healing however there are many fresh ones. I still feel confident that these are scabies. And I hope that the other students do not get infected.

Your thoughts please.

[rdsxfnrn]

cuz of the dr note your hands are tied. you did what you were supposed to. its on the doc now. i understand that you are concerned about the other children but there is nothing more you can do.

[Nurse_Ziba]

I think you've covered your part and the best thing to do right now is to encourage the class to practice proper hygiene and to educate the student not to scratch the affected area. You can also talk to the teacher and ask her to keep an eye on him and remind him not to scratch when he feels itchy. You can also ask the parent to make sure the affected area is covered before coming to school. This is to prevent it from getting infected and to serve as a barrier when he tries to scratch it. Don't tell the teacher that you feel it's scabies because the info might back fire on you. Make sure to keep the medical certificate on file and document the things you've done so that in case problems arise you have proof to back up your statements. :)

I know how frustrating this is - I encountered a similar incident 6 months ago. Hang on there!:)

[DistrictNurse19]

Have you thought of doing your own "unscientific" scabies test with the purple marker?? Draw a line using a purple marker across the rows of suspected scabies burrows. Wipe the purple marker off with an alcohol or antiseptic wipe. If it is a true scabies burrow, the purple ink will have penetrated into the path of the burrow (soaking in like a sponge). Also, did you consider "bed Bugs"? Oftentimes bed bug bites will show up in rows, and on various body parts like you described. maybe the parent and physician do not want to state "bed bugs" because of the embarassment and the fact that most likely the student is not taking bed bugs to school. Good luck!