255.2 📚 國考版

255.2.0.1 必背 — Scabies

• Sarcoptes scabiei; finger webs + wrists + axillae + scrotum + nighttime pruritus
• Burrows (pathognomonic linear gray-thread-like)
• Norwegian / Crusted in immunocompromise (HIV, transplant, elderly) — massive infestation, less itchy
• Treatment: permethrin 5% cream (topical, neck-to-toes overnight, repeat 1 wk) OR ivermectin 200 µg/kg PO × 2 doses 1-2 wk apart (preferred crusted + outbreaks)
• Treat all household contacts
• Wash clothing / bedding hot water or 72 hr bag

255.2.0.2 必背 — Lice

• Head, body, pubic lice (different species)
• Body lice = vector for epidemic typhus, trench fever, louse-borne relapsing fever
• Pubic lice = STI typically
• Treatment: permethrin 1% lotion, pyrethrin, malathion, ivermectin (topical or PO for resistant)

255.2.0.3 必背 — Bedbugs

• Cimex lectularius
• Linear / clustered pruritic papules (“breakfast/lunch/dinner”)
• Travel + hotels resurgence 2000s+
• Not vectors but significant burden
• Topical anti-itch + pest control

255.2.0.4 必背 — Myiasis

• Fly larvae in tissue
• Manual extraction (vaseline occlusion) or surgical
• Tumbu fly (Africa), Bot fly (Latin America), wound myiasis

255.2.0.5 必背 — Tungiasis

• Sand flea (Tunga penetrans); female burrows in toe
• Tropical; extraction

255.2.0.6 必背 — Insect-Vector Disease Quick

• Mosquito: malaria, dengue, Zika, chikungunya, yellow fever, JE, WNV, filariasis
• Tick: Lyme, RMSF, Babesia, Ehrlichia, Anaplasma, Powassan, tularemia
• Sandfly: Leishmania
• Tsetse fly: African trypanosomiasis
• Triatomine bug: Chagas
• Deer fly Chrysops: Loa loa
• Black fly Simulium: Onchocerciasis
• Body louse: epidemic typhus, trench fever, LBRF
• Flea: plague, murine typhus
• Chigger mite: scrub typhus

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