Difference between revisions of "Bed bugs"

(BB ref)
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==Background==
 
==Background==
*''Cimex lenticularis.''  
+
*''Cimex lenticularis''  
*Bed bug bites known as Cimicosis.
+
*Bed bug bites known as Cimicosis
*Attracted to CO2, warmth, exposed surfaces.
+
*Attracted to CO2, warmth, exposed surfaces
*Hide near beds, cracks, crevices. Feed at night.
+
*Hide near beds, cracks, crevices  
*May appear translucent (nymphs,) brown (mature bug,) red (after meal,) black (after digestion.)
+
*Feed at night
*Belong to Hemiptera like kissing bugs which are vectors for trypanosomiasis (Central and South America.)
+
*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==
 
==Clinical Features==
*Up to 20% of patients do not experience sx. (2)
+
*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:Bed bug, Cimex lectularius.jpg|thumb|Bed bug]]
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{{Ectoparasite DDX}}
 
{{Ectoparasite DDX}}
  
==Workup==
+
==Diagnosis==
 
Clinical diagnosis, based on history and physical exam.
 
Clinical diagnosis, based on history and physical exam.
  
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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 and other traditional approaches
  
 
==Disposition==
 
==Disposition==
Discharge if no systemic sx
+
Discharge if no systemic symptoms
  
 
==See Also==
 
==See Also==
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==External Links==
 
==External Links==
  
==Sources==
+
==References==
 
<references/>
 
<references/>
1. Schneir AB. Bites and Stings. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. New York, NY: McGraw-Hill; 2011.
 
 
2. 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.
 
 
3. Kolb A, Needham GR, Neyman KM, High WA (2009). "Bedbugs". Dermatol Ther 22 (4): 347–52. PMID 19580578.
 
  
 
[[Category:ID]]
 
[[Category:ID]]
 
[[Category:Derm]]
 
[[Category:Derm]]

Revision as of 16:03, 1 February 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

Diagnosis

Clinical diagnosis, based on history and physical exam.

Management

  • Antihistamine for pruritis
  • 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.