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Kinder- und Jugendmedizin 2020; 20(06): 384-392
DOI: 10.1055/a-1292-4692
Schwerpunkt

Pediculosis capitis

Infektionsepidemiologie, Diagnose, Therapie und PräventionHead lice infestationEpidemiology, diagnosis, treatment and prevention
Hermann Feldmeier∗
1   Institut für Mikrobiologie und Infektionsimmunologie, Charité Universitätsmedizin Berlin
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ZUSAMMENFASSUNG

Die Pediculosis capitis ist die häufigste parasitäre Hauterkrankung von Kindern. Kopfläuse können sich nur auf dem menschlichen Kopf vermehren. Es gibt kein Tierreservoir. Läuse benötigen alle 3–6 Stunden Blut. Außerhalb des Kopfes verlieren sie rasch ihre Infektiosität. Kopf- und Kleiderläuse sind potenzielle Überträger von wichtigen bakteriellen Pathogenen. Kopfläuse werden nahezu immer durch Kopf-zu-Kopf-Kontakt übertragen. Eine Übertragung über Textilien ist theoretisch denkbar, spielt aber praktisch keine Rolle. Eine stark juckende Kopfhaut, erythematöse Papeln und Quaddeln sind die typischen Symptome. Der starke Juckreiz ist eine allergische Reaktion auf Komponenten des Speichels der Kopflaus. Eine länger anhaltende bakterielle Superinfektion von Kratzexkoriationen führt zu einer regionalen Lymphadenopathie. Bei einer Erstinfestation treten die Symptome nach 4–6 Wochen auf, bei einer Reinfestation nach 24–48 Stunden. Die einzig zuverlässige Methode, um eine aktive Infestation zu erkennen, ist das systematische feuchte Auskämmen des gesamten Haares. Kopflausbefall tritt in spatio-temporalen Clustern in Form von Kleinepidemien auf: Familie, Spielkreis, Kindergarten, Schulklasse etc. Mädchen sind deutlich häufiger betroffen als Jungen. Nicht behandelte Träger von Kopfläusen sind für das Persistieren/Wiederaufflammen von Epidemien in Einrichtungen verantwortlich. Hochwirksame und sichere Therapeutika sind vorhanden.

ABSTRACT

Head lice infestation is the most common parasitic disease in childhood. Head lice can only reproduce on the human scalp. There is no animal reservoir. Head lice need to suck blood every 3–6 hours. When situated off-host, they lose their infectivity rapidly. Head lice are potential vectors of important bacterial pathogens. Head lice are transmitted almost always through head-to-head contact. A transmission via fomites is possible, but in practice only rarely occurs. The clinical pathology is characterized by intense itching of the scalp, erythematous papules and wheals. The intense itching is the result of an allergic reaction to components present in the saliva of the louse. Long lasting bacterial superinfection of excoriations of the scalp leads to a regional lymphadenopathy. After primary infestations symptoms and signs develop after4–6 weeks; after a re-infestation already after 24–48 hours. The only reliable diagnostic method is wet combing of the hair. Head lice infestation occurs in spatio-temporal clusters in the form of small epidemics. The incidence in girls is higher than in boys. Children not diagnosed with head lice or treated incorrectly are responsible for the persistence of epidemics. Highly effective and safe treatment options are available.

Schlüsselwörter

Pediculosis capitis - Infektionsepidemiologie - Diagnose - Therapie - Prävention

Keywords

Head lice infestation - epidemiology - diagnosis - treatment - prevention


Publication History

Received: 02 March 2020

Accepted: 23 March 2020

Article published online:
14 December 2020

© 2020. Thieme. All rights reserved.

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