What is the treatment for bird mite infestation?

Treatment for Bird Mite Infestation

The primary treatment for bird mite infestation is source elimination by removing bird nests and treating the environment with appropriate acaricides, combined with symptomatic relief using topical permethrin and antihistamines for the patient.

Immediate Source Control

The most critical step is identifying and eliminating the source of mites, which is typically bird nests in or near the home. 1, 2, 3

• Remove old bird nests from eaves, balconies, windows, and any areas where birds have nested 1, 2
• Eliminate access points where birds can nest near human habitation 4, 5
• The mites (Dermanyssus gallinae or Ornithonyssus species) live in cracks and crevices near bird housing during the day and attack hosts at night 2, 3
• Without source removal, treatment will fail as reinfestation will continue 1, 3

Patient Treatment

Topical Therapy

• Apply 1% permethrin shampoo initially for scalp involvement 4
• If inadequate response, escalate to 5% permethrin cream or lotion 4
• 10% crotamiton lotion can be used as an alternative or adjunct 4
• Antihistamines for symptomatic relief of pruritus 5
• Corticosteroids may be needed in severe cases with persistent inflammation 5

Expected Timeline

• Most cases resolve within one week of appropriate treatment combined with source elimination 5
• Refractory cases requiring corticosteroids may take longer 5

Environmental Decontamination

Thorough environmental treatment is essential to prevent reinfestation. 4

• Apply acaricide insecticides including:
  • Carbamates (carbolineum, trichlorfon, malathion, tetrachlorvinphos) 4
  • Organophosphates 4
  • Pyrethroids in spray or powder formulations 4
• Repair all cracks and crevices in walls, ceilings, and structures where mites can hide 4
• Wash all clothing and bedding with detergent 4
• Clean household items with appropriate acaricides 4
• Remove unused animal shelters, cages, and nests from living areas 4
• Increase ambient temperature above 45°C if possible, as heat kills mites 4
• Ensure proper ventilation of living spaces 4

Diagnostic Considerations

Bird mite infestation is frequently misdiagnosed, leading to unnecessary treatments for scabies or lice. 1, 3, 5

• The mites are extremely small (<1 mm) and move rapidly, making them difficult to visualize 1, 3
• Patients typically present with itchy papular or papulovesicular eruptions that are unresponsive to antihistamines 1, 2
• Key diagnostic clue: sensation of insects moving on the skin, with symptoms worsening in the evenings 4, 2
• Always inquire about contact with birds, bird nests, or proximity to poultry/pigeon habitats 4, 5
• Mites can be collected from skin, clothing, or surfaces near the patient for microscopic identification 4, 3

Common Pitfalls

• Treating as scabies or lice without identifying the source leads to treatment failure and unnecessary expense 3
• Failing to ask about bird exposure in patients with nonspecific pruritic eruptions 5
• Treating only the patient without environmental decontamination results in rapid reinfestation 1, 4
• The mites attack humans when their avian hosts disappear or are inaccessible, particularly affecting people living near bird nesting sites 2, 5