Lice Nightmare

Patient: Doctor, i have got these enlarged lymph nodes in my neck.They are painful.
Me: Let me see,how long have u been having them?
***I went in to a detailed history.
Patient:oh,just a month or so...(and so she goes answering my questions)
Me:Let me examine your neck and axilla please.Please take off your head covering.
(I went on examining for lymph nodes and found enlarged tender right deep cervical lymph nodes.Axilla and supraclavicular area were free.
Just when i finished examining..
Patient:And doctor, i have these "things" in my scalp.I cant seem to get rid of these "places".
I went and examined a spot she indicated with her index finger.Tried to seperate hair strands from the tightly tied back hair.I saw flaky seborrhic dermatitis from the look of it.I was about to do some more looking at her scalp when i noticed them....Crawling liesurely along her hair.As if they belonged there.
I took a step back and placed my right hand at the rim of the wash sink near the examining table and the other on my hip.I looked nonchalant as i told her that she has got lice infestation.
I discharged her after prescribing the antibiotics for the lymph node inflammation with advises to follow up and with a referal to the dermatology clinic in her hand.
Point to ponder: I haven't seen lice infestation ever since i left primary school and it was a bit of a shock to see them,those bugs so close.Brought back the "lice nightmares" i had to endure during my childhood.The more my mom cleaned my head from them, the more i got them from school buddies.