Difference between revisions of "Bed bugs"

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==Background==
 
==Background==
 
*''Cimex lenticularis''  
 
*''Cimex lenticularis''  
*Bed bug bites known as Cimicosis
+
*Bed bug bites are known as 'cimicosis'
*Attracted to CO2, warmth, exposed surfaces
+
*Bed bugs are attracted to CO2, warmth, exposed surfaces
*Hide near beds, cracks, crevices  
+
*Tend to hide near beds, cracks, crevices
 
*Feed at night
 
*Feed at night
 
*May appear translucent (nymphs,) brown (mature bug,) red (after meal,) black (after digestion)
 
*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)
+
*Belong to ''Hemiptera'' (like kissing bugs) which are vectors for trypanosomiasis (Central and South America)
  
 
==Clinical Features==
 
==Clinical Features==
 +
[[File:Bed bug, Cimex lectularius.jpg|thumb|Bed bug]]
 +
[[File:Bedbug_with_classic_hemmoragic_appearance_and_punctate_center_2014-09-28_19-01.jpg|thumbnail|Bedbug with classic hemmoragic appearance and punctate center]]
 +
 
*Up to 20% of patients do not experience symptoms<ref>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.</ref>
 
*Up to 20% of patients do not experience symptoms<ref>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.</ref>
 
*Pain immediately after bite
 
*Pain immediately after bite
 
*Erythematous papules, bullae, and wheals may take days to develop
 
*Erythematous papules, bullae, and wheals may take days to develop
 
*Classic line of bites: "breakfast, lunch, and dinner"
 
*Classic line of bites: "breakfast, lunch, and dinner"
[[File:Bed bug, Cimex lectularius.jpg|thumb|Bed bug]]
 
[[File:Bedbug_with_classic_hemmoragic_appearance_and_punctate_center_2014-09-28_19-01.jpg|thumbnail|Bedbug with classic hemmoragic appearance and punctate center]]
 
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
 
{{Ectoparasite DDX}}
 
{{Ectoparasite DDX}}
 +
{{Hand Infection DDX}}
  
==Diagnosis==
+
==Evaluation==
Clinical diagnosis, based on history and physical exam.
+
*Clinical diagnosis, based on history and physical exam.
  
 
==Management==
 
==Management==
*Antihistamine for pruritis
+
*Primarily supportive care
*Consider topical steroids to decrease inflammation
+
*[[Antihistamine]] for [[pruritus]]
 +
*Consider [[topical steroids]] to decrease inflammation
 
**No evidence that medications improve outcomes
 
**No evidence that medications improve outcomes
 
*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==
Discharge if no systemic symptoms
+
*Discharge if no evidence of systemic symptoms or anaphylaxis
  
 
==See Also==
 
==See Also==
*[[Parasitic Diseases]]
+
*[[Parasitic diseases]]
*[[Travel Medicine]]
+
*[[Travel medicine]]
  
 
==External Links==
 
==External Links==

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.