- 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.)
- 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"
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
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.