Difference between revisions of "Bed bugs"

(Text replacement - "==Diagnosis==" to "==Evaluation==")
(Text replacement - "pruritis" to "pruritus")
Line 23: Line 23:
  
 
==Management==
 
==Management==
*Antihistamine for pruritis
+
*Antihistamine for pruritus
 
*Consider topical steroids to decrease inflammation
 
*Consider topical steroids to decrease inflammation
 
**No evidence that medications improve outcomes
 
**No evidence that medications improve outcomes

Revision as of 16:43, 27 October 2016

Background

  • Cimex lenticularis
  • Bed bug bites known as Cimicosis
  • Attracted to CO2, warmth, exposed surfaces
  • 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

  • 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"
Bed bug
Bedbug with classic hemmoragic appearance and punctate center

Differential Diagnosis

Domestic U.S. Ectoparasites

See also travel-related skin conditions

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 systemic symptoms

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.