Bed bugs

Last reviewed: 20 Apr 2022
Last updated: 01 Dec 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • bed bug sighting
  • irregular linear erythematous papules
  • new skin lesions noted in the morning
  • pruritus
More key diagnostic factors

Other diagnostic factors

  • pain or burning
  • papular or diffuse urticaria
  • bullae
  • widespread urticaria/wheezing/stridor/hypotension
  • specks of blood or faeces on sheets
Other diagnostic factors

Risk factors

  • high-turnover environment
  • recent travel
  • second-hand furniture in the home
More risk factors

Diagnostic investigations

Investigations to consider

  • skin scraping of lesion (mineral oil preparation)
  • skin biopsy
More investigations to consider

Treatment algorithm

ACUTE

symptomatic disease

Contributors

Authors

Julian J. Trevino, MD

Professor of Dermatology

Chair

Department of Dermatology

Boonshoft School of Medicine

Wright State University

Dayton

OH

Disclosures

JJT declares that he has no competing interests.

Elizabeth Usedom, MD, MS

Dermatology Resident Physician

Department of Dermatology

Boonshoft School of Medicine

Wright State University

Dayton

OH

Disclosures

EU declares that she has no competing interests.

Acknowledgements

Dr Julian Trevino and Dr Elizabeth Usedom would like to gratefully acknowledge Dr Suzanna Dundon and Dr David Carr, previous contributors to this topic.

Disclosures

SD and DRC declare that they have no competing interests.

Peer reviewers

Richard deShazo, MD

Chairman and Professor

Department of Medicine

Professor of Pediatrics

Billy S. Guyton Distinguished Professor

University of Mississippi Medical Center

Jackson

MS

Disclosures

RD declares that he has no competing interests.

Xuan Nguyen, MD

Faculty Physician

Dermatology and Pediatric Dermatology

Phoenix Children's Hospital

Phoenix

AZ

Disclosures

XN declares that she has no competing interests.

Ian F. Burgess, MSc, MPhil

Professor

Director

Medical Entomology Centre

University of Cambridge

Cambridge

UK

Disclosures

IFB has been a consultant to various manufacturers of pharmaceutical products, alternative therapies, and combs for treating louse infections. IFB is an author of a number of references cited in this topic.

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