Background
Microbiology
- Cimex species (primarily Cimex lectularius and Cimex hemipterus) cause bed bug infestations
- Insect with well-developed eyes and head with a flat, round body, that can become engorged and round after feeding
Epidemiology
- Almost eradicated from developed countries due to widespread use of DDT, but is now reemerging
- Have never been confirmed to carry infection, though some unconfirmed hypotheses that can transmit hepatitis B and E
- Night feeding, feeding for 5 to 10 minutes before leaving to digest
- Can hide essentially anywhere in any dark crevice, even telephones, cracks in walls, drawers, baseboards, etc
Clinical Manifestations
- Bites are typically on exposed areas, such as face, neck, and hands or arms
- May have hemorrhagic puncta
- Sometimes three linear bites ("breakfast, lunch and dinner")
Differential Diagnosis
- Cimex adjunctus (bat bugs): develops in colonies of roosting bats (e.g. in attics or walls of building), and can transiently infest human areas; bug appears similar, but without the bats they cannot reproduce
- Oeciacus vicarius (swallow bugs): swallow nests, with bites usually in late winter or early spring where they transiently move into human habitat and bite humans
Diagnosis
- Diagnosis is made by seeing bedbugs in the environment
Management
- There is no treatment, except to supportively treat the pruritus (topical corticosteroids, crotamiton, or antihistamines)
- Environment needs to be decontaminated, so call an exterminator
Prevention
- Place legs of legs in water or paraffin to prevent bugs from crawling into bed
- Permethrin-impregnated bednet, which must be carefully tucked under the mattress
- Environmental insecticides
