Difference between revisions of "Bed bugs"

(Differential Diagnosis)
 
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==Differential Diagnosis==
 
==Differential Diagnosis==
 
{{Ectoparasite DDX}}
 
{{Ectoparasite DDX}}
 +
{{Hand Infection DDX}}
  
 
==Evaluation==
 
==Evaluation==
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==Management==
 
==Management==
 +
*Primarily supportive care
 
*[[Antihistamine]] for [[pruritus]]
 
*[[Antihistamine]] for [[pruritus]]
 
*Consider [[topical steroids]] to decrease inflammation
 
*Consider [[topical steroids]] to decrease inflammation
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*Treat systemic reactions similar to [[anaphylaxis]] (rare)
 
*Treat systemic reactions similar to [[anaphylaxis]] (rare)
 
*Self-limited 1-2 weeks without treatment
 
*Self-limited 1-2 weeks without treatment
*Eradication using pesticides and other traditional approaches
+
*Eradication using pesticides, hot water washing of bedding
  
 
==Disposition==
 
==Disposition==

Latest revision as of 21:33, 28 January 2020

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

Domestic U.S. Ectoparasites

See also travel-related skin conditions

Hand and finger infections

Evaluation

  • Clinical diagnosis, based on history and physical exam.

Management

  • Primarily supportive care
  • 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, hot water washing of bedding

Disposition

  • Discharge if no evidence of systemic symptoms 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.