SCABIES WITH SECONDARY BACTERIAL INFECTION IN A BOARDING SCHOOL STUDENT: A CASE REPORT
Abstract
Scabies is a contagious parasitic skin disease caused by Sarcoptes scabiei var. hominis. A 14-year-old male student residing in an Islamic boarding school presented to a public health centre with a long-standing history of scab-like skin lesions. The patient had sought treatment for more than one month without clinical improvement. He complained of intense nocturnal pruritus affecting the interdigital spaces and palms, accompanied by erythematous lesions, excoriations, vesicles, purulent discharge, swelling, pain, and fever. He also reported pain in the axillary and inguinal regions. Physical examination revealed multiple discrete erythematous papules and vesicles on the interdigital spaces and palms, accompanied by crusts, excoriations, and purulent discharge. Enlarged and tender axillary lymph nodes were also noted. Based on clinical findings, the patient was diagnosed with scabies complicated by secondary bacterial infection. Non-pharmacological management included patient and family education regarding the disease, personal hygiene, environmental sanitation, and a visit to the boarding school to prevent further transmission. Pharmacological therapy consisted of oral antibiotics, analgesics, antihistamines, and anti-inflammatory agents. Topical treatment included anti-scabietic therapy and a combination of topical antibiotic and anti-inflammatory agents. Scabies may be complicated by secondary bacterial infection due to delayed diagnosis and treatment, persistent scratching, and poor personal and environmental hygiene. Overcrowded living conditions, such as those in boarding schools, facilitate transmission and increase the risk of complications. A family-centred and community-based approach, particularly involving boarding school environments, plays a crucial role in controlling transmission and improving outcomes in patients with scabies complicated by secondary infection.
References
Al-Dabbagh, J., Younis, R., & Ismail, N. (2023). The currently available diagnostic tools and treatments of scabies and scabies variants: an updated narrative review. Medicine, 102(21), e33805.
Gunardi, K. Y., Sungkar, S., Irawan, Y., & Widaty, S. (2022). Level of Evidence in Diagnosing Scabies Based on The Oxford Centre for Evidence-Based Medicine. eJournal Kedokteran Indonesia, 10(3), 276–283.
Gupta, S., Thornley, S., Morris, A., Sundborn, G., & Grant, C. (2024). Prevalence and determinants of scabies: A global systematic review and meta‐analysis. Tropical Medicine & International Health, 29(12), 1006-1017.
Hasti, A. G., Abdi, D. A., Surdam, Z., Fattah, N., & Yuniati, L. (2024). Personal Hygiene and Environmental Sanitation Factors that Influence the Incidence of Scabies in Al-Bayan. Green Medical Journal, 6(1), 34-44.
Matthewman, J., Manego, R. Z., Dimessa Mbadinga, L. B., Šinkovec, H., Völker, K., Akinosho, M., ... & Mombo-Ngoma, G. (2020). A randomized controlled trial comparing the effectiveness of individual versus household treatment for Scabies in Lambaréné, Gabon. PLoS neglected tropical diseases, 14(6), e0008423.
May, P. J., Tong, S. Y., Steer, A. C., Currie, B. J., Andrews, R. M., Carapetis, J. R., & Bowen, A. C. (2019). Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review. Tropical Medicine & International Health, 24(3), 280-293.
Engelman, D., Yoshizumi, J., Hay, R. J., Osti, M., Micali, G., Norton, S., ... & Fuller, L. C. (2020). The 2020 international alliance for the control of scabies consensus criteria for the diagnosis of scabies. British Journal of Dermatology, 183(5), 808-820.
Iyengar, L., Chong, A. H., & Steer, A. C. (2024). Scabies: a clinical update. Medical Journal of Australia, 221(10), 558-563.
Leung, A. K., Lam, J. M., & Leong, K. F. (2020). Scabies: a neglected global disease. Current pediatric reviews, 16(1), 33-42.
Oktarina, C., Surya, D., Gerynda, S. P. M., Putera, M. T. H., & Widaty, S. (2021). Association between nutritional status and scabies infestation in a boarding school in Indonesia: a crosssectional study. Iranian Journal of Dermatology, 24, 280-285.
Ong, C. Y., & Vasanwala, F. F. (2018). Infected with scabies again? focus in management in long-term care facilities. Diseases, 7(1), 3.
Osti, M. H., Sokana, O., Gorae, C., Whitfeld, M. J., Steer, A. C., & Engelman, D. (2019). The diagnosis of scabies by non-expert examiners: A study of diagnostic accuracy. PLoS neglected tropical diseases, 13(8), e0007635.
Puspita, S. I. A., Ardiati, F. N., Adriyani, R., & Harris, N. (2021). Factors of personal hygiene habits and scabies symptoms at Islamic boarding school. Jurnal Promkes, 9(2), 91-100.
Richards, R. N. (2021). Scabies: diagnostic and therapeutic update. Journal of cutaneous medicine and surgery, 25(1), 95-101.
Siddig, E. E., & Hay, R. (2022). Laboratory-based diagnosis of scabies: a review of the current status. Transactions of the Royal Society of Tropical Medicine and Hygiene, 116(1), 4-9.
Tsoi, S. K., Lake, S. J., Thean, L. J., Matthews, A., Sokana, O., Kama, M., ... & Engelman, D. (2021). Estimation of scabies prevalence using simplified criteria and mapping procedures in three Pacific and southeast Asian countries. BMC public health, 21(1), 2060.
Ulya, U. (2023). Relationship Between Knowledge, Attitude, and Personal Hygiene With Scabies Incidence at the Daarul Ilmi Cengklong Islamic Boarding School 2022. Muhammadiyah International Public Health and Medicine Proceeding, 3(1), 339-347.
van der Linden, N., van Gool, K., Gardner, K., Dickinson, H., Agostino, J., Regan, D. G., ... & Viney, R. (2019). A systematic review of scabies transmission models and data to evaluate the cost-effectiveness of scabies interventions. PLoS neglected tropical diseases, 13(3), e0007182.
Wahdini, S., Sungkar, S., Widaty, S., Nurcandra, F., & Sari, I. P. (2025). Scabies and related factors among students in a traditional urban Islamic boarding school. Discover Public Health, 22(1), 754.
Walker, S. L., Collinson, S., Timothy, J., Zayzay, S. K., Kollie, K. K., Candy, N., ... & Marks, M. (2020). A community-based validation of the International Alliance for the Control of Scabies Consensus Criteria by expert and non-expert examiners in Liberia. PLoS Neglected Tropical Diseases, 14(10), e0008717.
Widaty, S., Kekalih, A., Bramono, K., Sari, S. M., Darmawan, I., & Friska, D. (2024). Scabies Training for Improving Non-Medical Personnel Knowledge in High-Risk Population in Indonesia. eJournal Kedokteran Indonesia, 12(3), 245-245.
Widaty, S., Krisanti, R. I. A., Rihatmadja, R., Miranda, E., Marissa, M., Arsy, M., ... & Menaldi, S. L. (2019). Development of “Deskab” as an instrument to detect scabies for non-medical personnel in Indonesia. Dermatology Reports, 11(s1).
Widaty, S., Miranda, E., Cornain, E. F., & Rizky, L. A. (2022). Scabies: update on treatment and efforts for prevention and control in highly endemic settings. The Journal of Infection in Developing Countries, 16(02), 244-251.
Widaty, S., Saputra, J., Suprapto, N., Natasha, J., Azis, M. H., Lestarini, D., ... & Irawan, Y. (2023). Characteristic of Skin Diseases in Two Public Boarding Schools Occupantsin West Java 2018. eJournal Kedokteran Indonesia, 14-14.
World Health Organization (WHO). (2008). Task Shifting: Global Recommendations and Guidelines. Geneva: WHO.
Copyright (c) 2025 AKSELERASI: Jurnal Ilmiah Nasional

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.




1.png)



1.png)