小结
定义
床虫（床虱、热带床虫和鲍细床虫）是红褐色、无翅的专性食血（仅摄食血液）寄生虫，长约 5 mm 至 7 mm。[1][2] “普通床虱”（温带床虱）在温带气候中更为常见，而热带床虱 (C hemipterus) 一般分布于热带地区，鲍细床虱 (L boueti) 分布于非洲西部。它们肉眼可见，一般藏匿于床垫、床底板和床头板的缝隙中，也可藏匿在踢脚板背面。床虱为夜行性（活跃于夜间），它们更愿意在宿主活动极少时进食。[3] 该病的典型病变是睡眠时暴露的皮肤上的红斑性、瘙痒性丘疹。病变可能出现于被叮咬后的数小时至数天。床虱不太可能是疾病传播载体；因此，治疗目标是对症控制和避免这种寄生虫。[4][Figure caption and citation for the preceding image starts]: 床虱，采集于乔治亚州市区的一家宾馆由 CDC 提供 [Citation ends].
[Figure caption and citation for the preceding image starts]: 床虱由 CDC 提供 [Citation ends].
[Figure caption and citation for the preceding image starts]: 床虫咬处出现许多红斑性丘疹资料来自提供者的个人教学作品集 (Julian J. Trevino, David R. Carr, Suzanne L. Dundon)；经授权使用 [Citation ends].
[Figure caption and citation for the preceding image starts]: 丘疹的线状分布资料来自提供者的个人教学作品集 (Julian J. Trevino, David R. Carr, Suzanne L. Dundon)；经授权使用 [Citation ends].
病史和体格检查
关键诊断因素
- 存在的危险因素
- 目击到床虫
- 不规则线状分布的红色丘疹
- 在早晨注意到新的皮疹。
- 瘙痒
其他诊断因素
- 疼痛或烧灼感
- 丘疹性或泛发性荨麻疹
- 大疱
- 泛发性荨麻疹/哮鸣/喘鸣/低血压
- 床单上发现血斑或粪斑
危险因素
- 高流动环境
- 近期旅行过
- 家中存在二手家具
诊断性检查
需考虑的检查
- 患处皮肤刮片（矿物油制剂）
- 皮肤活检
治疗流程
症状性疾病
撰稿人
作者
Julian J. Trevino, MD
Professor of Dermatology
Chair
Department of Dermatology
Boonshoft School of Medicine
Wright State University
Dayton
OH
利益声明
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
利益声明
EU declares that she has no competing interests.
鸣谢
Dr Julian Trevino and Dr Elizabeth Usedom would like to gratefully acknowledge Dr Suzanna Dundon and Dr David Carr, previous contributors to this topic.
利益声明
SD and DRC declare that they have no competing interests.
同行评议者
Richard deShazo, MD
Chairman and Professor
Department of Medicine
Professor of Pediatrics
Billy S. Guyton Distinguished Professor
University of Mississippi Medical Center
Jackson
MS
利益声明
RD declares that he has no competing interests.
Xuan Nguyen, MD
Faculty Physician
Dermatology and Pediatric Dermatology
Phoenix Children's Hospital
Phoenix
AZ
利益声明
XN declares that she has no competing interests.
Ian F. Burgess, MSc, MPhil
Professor
Director
Medical Entomology Centre
University of Cambridge
Cambridge
UK
利益声明
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.
鉴别诊断
- 虫咬或蜘蛛咬伤
- 荨麻疹
- 疥疮
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