Bed bugs

Background

  • Cimex lenticularis
  • Bed bug bites are known as 'cimicosis'
  • Bed bugs are attracted to CO2, warmth, exposed surfaces
  • Tend to hide near beds, cracks, crevices
  • Feed at night
  • May appear translucent (nymphs,) brown (mature bug,) red (after meal,) black (after digestion)
  • Belong to Hemiptera (like kissing bugs) which are vectors for trypanosomiasis (Central and South America)

Clinical Features

Bed bug
Bedbug with classic hemmoragic appearance and punctate center
  • Up to 20% of patients do not experience symptoms[1]
  • Pain immediately after bite
  • Erythematous papules, bullae, and wheals may take days to develop
  • Classic line of bites: "breakfast, lunch, and dinner"

Differential Diagnosis

Ectoparasites

Evaluation

  • Clinical diagnosis, based on history and physical exam.

Management

  • Antihistamine for pruritus
  • Consider topical steroids to decrease inflammation
    • No evidence that medications improve outcomes
  • Treat systemic reactions similar to anaphylaxis (rare)
  • Self-limited 1-2 weeks without treatment
  • Eradication using pesticides and other traditional approaches

Disposition

  • Discharge if no evidence of systemic sx or anaphylaxis

See Also

External Links

References

  1. Jerome Goddard & Richard deShazo (2009). "Bed bugs (Cimex lectularius) and clinical consequences of their bites". Journal of the American Medical Association 301 (13): 1358–1366. PMID 19336711.