Death by lice? - A case of fatal secondary anaemia following severe lice infestation

Head lice are generally considered harmless but in rare cases, a prolonged infestation can lead to severe consequences even resulting in the individuals' death. This article presents the case of a 56-year-old man who died from severe secondary anaemia most probably caused by prolonged and pronounced lice infestation. The man, who lived in poor hygienic conditions and suffered from schizophrenia and alcohol addiction, was found breathing heavily on the floor of his apartment and later died during the emergency measures. His body was covered in thousands of lice, even affecting his respiratory openings and the oesophagus. Autopsy and histopathological results revealed iron deficiency anaemia and signs of a long-term lice infestation. While other contributing factors such as hypothermia and alcohol withdrawal syndrome had to be discussed as contributory factors, the findings suggested that lice-induced anaemia was the primary cause of death. The case highlights the need for awareness about the potentially fatal consequences of untreated lice infestations, particularly in vulnerable populations. To our knowledge, it is the first death case due to lice infestation in the European Union.