Abstract
INTRODUCTION: Iron deficiency anemia is commonly seen in the emergency department (ED), and the cause can be complex and variable. CASE REPORT: We present a case of a female without known medical history who presented to the ED for generalized weakness and was found to have severe anemia in the setting of chronic lice infestation. CONCLUSION: Severe and chronic pediculosis can cause chronic blood loss and be an unusual and rare cause of iron deficiency anemia. In the setting of anemia and hypotension unresponsive to fluid resuscitation, consideration should be given to early packed red blood cell transfusion and subsequent investigation of causes of severe anemia.