Internal Medicine

0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:18

1144 Patent Ductus Arteriosus Pediculosis

follow-up

■No endocarditis prophylaxis required after curative surgery

complications and prognosis

Complications

■Potential for infective endarteritis before surgical correction

■CHF may develop due to long term left-to-right shunting

■Eisenmenger’s physiology: occurs with large PDA due to progressive

right-sided pressure and volume overload from long term left-to-

right shunting. Results in pulmonary hypertension and reversal of

shunt.

Prognosis

■Near normal long-term survival for PDA corrected in childhood

■Survival in later repair depends on presence of pulmonary vascular

disease and LV dilation

PEDICULOSIS

MICHAEL DACEY, MD and JEFFREY P. CALLEN, MD

REVISED BY JEFFREY P. CALLEN, MD

history & physical

■Can occur at any age, independent of hygiene

■Three types: corporis (body), capitis (scalp), pubis (groin)

■Transmitted person to person, or via fomites (blankets, combs,

towels); overcrowded conditions are a risk factor

■Pruritus becomes extreme, often accompanied by excoriations and

secondary infection (especially impetigo), local adenopathy

■Egg sacs, or nits, found on proximal hair shaft on scalp, groin

■Organisms seen in pubic hair of adults; eyelashes of children

tests

■No systemic work up required

differential diagnosis

■Scalp: seborrheic dermatitis, psoriasis, atopic eczema, delusions of

parasitosis

■Body: acne, xerosis, dermatitis herpetiformis, delusions of parasito-

sis, scabies

■Groin: tinea cruris, candidiasis, intertrigo, folliculitis