Bed bugs

Revision as of 04:52, 22 January 2016 by 3amrbadawy (talk | contribs) (BB clinical)


  • 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 sx. (2)
  • 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


Clinical diagnosis, based on history and physical exam.


  • 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.


Discharge if no systemic sx

See Also

External Links


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.