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Nosocomial dermatitis and pruritus caused by pigeon mite infestation
A M Regan1, M L Metersky, D E Craven
1Department of Nursing, Boston City Hospital MA 02118.
Abstract:
We report an outbreak of pigeon mite infestation involving two patients, two nurses, and one physician on a medical ward in a municipal hospital. The index patient developed a diffuse, pruritic erythematous maculopapular rash on his trunk and extremities. Dermanyssus gallinae, a nonburrowing, blood-sucking avian mite was identified on the patient and his bedding. A second patient who complained of scalp pruritus had mites present on her pillow and bed linen. The intern taking care of both patients, and two nurses who had contact with these patients, had mite infestation. Pigeons roosting on the air conditioners and near the doors connecting the patients' rooms to a sunporch were the source of the mites. The outbreak abated after control measures were instituted that prevented pigeons from roosting on the porch. This outbreak illustrates an unusual cause of nosocomial pruritic dermatitis that may be misdiagnosed as scabies or pediculosis. Physicians and health care personnel working in metropolitan areas are alerted to mites as a cause of pruritic dermatitis that may be chronic, recurrent, or unresponsive to ectoparasiticides.
Insights
An outbreak of pigeon mite (Dermanyssus gallinae) infestation occurred in a hospital ward, affecting patients and staff. Control measures targeting pigeon roosting sites successfully resolved the pruritic dermatitis outbreak.
Area of Science:
- Dermatology
- Infectious Diseases
- Public Health
Background:
- Nosocomial infections can arise from various sources, including environmental factors and animal vectors.
- Pruritic dermatitis in healthcare settings can be challenging to diagnose and manage, often mimicking other common conditions.
Observation:
- An unusual outbreak of pigeon mite (Dermanyssus gallinae) infestation affected two patients, two nurses, and one physician on a hospital medical ward.
- Affected individuals presented with pruritic, erythematous maculopapular rashes and scalp pruritus.
- Pigeon mites were identified on patients, their bedding, and pillows, with pigeons identified as the source roosting near patient rooms.
Findings:
- The outbreak was linked to pigeons roosting on air conditioners and near patient room access points.
- Implementation of control measures to prevent pigeon roosting led to the abatement of the mite infestation.
- The condition mimicked scabies or pediculosis, highlighting potential diagnostic challenges.
Implications:
- This case highlights an uncommon cause of nosocomial pruritic dermatitis that requires recognition by healthcare professionals.
- Physicians and healthcare workers in urban environments should consider avian mites as a potential cause of chronic or treatment-resistant pruritic rashes.
- Effective environmental control measures are crucial for preventing and managing such outbreaks in healthcare facilities.