# The Deadly Itch: A Rare but Fatal Case of Norwegian Scabies

## TL;DR

A 65-year-old man with diabetes and epilepsy died from severe Norwegian scabies despite treatment, emphasizing the need for early diagnosis and strict infection control.

## Contribution

This paper presents a fatal case of Norwegian scabies in an immunocompromised patient, highlighting clinical challenges and management strategies.

## Key findings

- Norwegian scabies can lead to severe complications like staphylococcal bacteremia and multi-organ failure in immunocompromised patients.
- Aggressive treatment with ivermectin, permethrin, and IV antibiotics failed to prevent death in this case due to sepsis.
- Early diagnosis and strict infection control are critical to prevent fatal outcomes in Norwegian scabies.

## Abstract

Norwegian (crusted) scabies is a rare but highly contagious variant of scabies that predominantly affects immunocompromised individuals, such as those with diabetes or neurological disorders. The condition is characterised by hyperkeratotic plaques teeming with mites, often leading to secondary bacterial infections and life-threatening complications. We present a fatal case of Norwegian scabies in a 65-year-old male with epilepsy and diabetes, who developed severe skin infestation, staphylococcal bacteremia, and multi-organ failure. Despite receiving aggressive treatment with oral ivermectin, topical permethrin, and IV antibiotics, the patient deteriorated and succumbed to sepsis. This case highlights the importance of early diagnosis, aggressive management, and strict infection control to prevent adverse outcomes.