Bed bugs

Nocturnal, obligate blood-feeding parasites that take refuge in furniture and bedding.

Reports of bites are increasing in prevalence. Bites are painless but cause discomfort owing to the associated reactions.

Characteristic lesions are pruritic papules in an irregular linear pattern, typically found on body surfaces exposed during sleeping such as face, neck, arms, legs, and shoulders.

Treatment is symptomatic and includes antihistamines, topical antipruritics, and topical corticosteroids. In severe cases, systemic corticosteroids may be necessary.

Elimination from the home is essential and may require professional extermination.

Transmission of blood-borne infection is highly unlikely.

Bed bugs (Cimex lectularius, C hemipterus, and Leptocimex boueti) are reddish-brown, wingless, obligate hematophagous (feeding only on blood) parasites approximately 5 to 7 mm in length.[1]Steen CJ, Carbonaro PA, Schwartz RA. Arthropods in dermatology. J Am Acad Dermatol. 2004;50:819-842. http://www.ncbi.nlm.nih.gov/pubmed/15153881?tool=bestpractice.com [2]Goddard J, deShazo R. Bedbugs (Cimex lectularius) and clinical consequences of their bites. JAMA. 2009 Apr 1;301(13):1358-66. http://jama.jamanetwork.com/article.aspx?articleid=183643 http://www.ncbi.nlm.nih.gov/pubmed/19336711?tool=bestpractice.com The "common bed bug" (Cimex lectularius) is more prevalent in temperate climates, whereas C hemipterus is generally found in tropical areas, and L boueti is found in western Africa. They are visible with the human eye and generally hide in the crevices of mattresses, box springs, bed headboards, and behind baseboards. Bed bugs are nocturnal (active at night), as they prefer to feed during minimal host activity.[3]Reinhardt K, Siva-Jothy MT. Biology of the bedbugs (Cimicidae). Ann Rev Entomol. 2007;52:351-74. http://www.ncbi.nlm.nih.gov/pubmed/16968204?tool=bestpractice.com Typical lesions are erythematous, pruritic papules on skin exposed while sleeping. Lesions may appear hours to days after being bitten. Bed bugs are unlikely vectors of disease; therefore, treatment is symptomatic control and avoidance of the parasite.[4]Potter M. Bed bugs. University of Kentucky, Cooperative Extension Service. Online entfact - 636. 2008. http://www.ca.uky.edu [internet publication]. http://www.ca.uky.edu/entomology/entfacts/entfactpdf/ef636.pdf [Figure caption and citation for the preceding image starts]: Cimex lectularius, collected in a hotel in urban GeorgiaCourtesy of the CDC [Citation ends].[Figure caption and citation for the preceding image starts]: Cimex lectulariusCourtesy of the CDC [Citation ends].[Figure caption and citation for the preceding image starts]: Bed bug bites showing numerous erythematous papulesFrom the contributors' personal teaching collection (Julian J. Trevino, David R. Carr, Suzanne L. Dundon); used with permission [Citation ends].[Figure caption and citation for the preceding image starts]: Linear distribution of papulesFrom the contributors' personal teaching collection (Julian J. Trevino, David R. Carr, Suzanne L. Dundon); used with permission [Citation ends].