Bed Bugs is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Nocturnal obligate blood parasites residing in furniture and bedding
  • 5 to 7 mm oval, reddish brown, flat, wingless

Epidemiology

Incidence
  • Bed bug infestations increasing and difficult to treat, more so than cockroaches, termites, and ants (1)[B]
  • Resurgence due to changes in pesticide increased travel, use of secondhand furniture, and high turnover rates of hotel guests.

Prevalence
  • Infestations are increasing across the United States.
  • Bed bugs have increased 10–30% in public places (schools, hospitals, hotels/motels, aircrafts) over the past decade (2)[B].

Etiology and Pathophysiology

  • Insect family Cimicidae
  • Three species bite humans: Cimex lectularius, Cimex hemipterus, and Leptocimex boueti (2)[B].
  • Most prevalent species is C. lectularius (2)[B].
  • Found in tropical and temperate climates
  • Hide in crevices of mattresses, box springs, headboards, and baseboards
  • Infestations occur in hotels/motels, hospitals, cinemas, vehicles, aircraft, and homes.
  • Reactions range from an absent or minimal response to the typical pruritic, erythematous maculopapular rash. Less commonly, there is an urticarial or anaphylactoid response.
  • Skin reactions are due to host immunologic response to parasite salivary proteins.
  • Urticarial reactions are mediated via immunoglobulin (Ig) G antibody response to salivary proteins (3)[B].
  • Bullous reactions caused by an IgE-mediated hypersensitivity to nitrophorin in bug saliva (3)[B]
  • Bugs are attracted to body warmth and exhaled carbon dioxide (4).
  • Bites do not transmit other known pathogens.

General Prevention

  • Traps typically use carbon dioxide and heat to attract and trap bugs but can be cost prohibitive (5)[B].
  • Vector control: Vacuum regularly, reduce clutter, seal cracks in walls, inspect luggage and clothing.
  • Launder all bedding and clothing in >130°F (50°C) for 2 hours or place in 20°F (−5°C) or cooler environment for at least 5 days.
  • If present in the home, eradication using professional extermination services. Some pest control companies use canines to detect live bed bugs and eggs based on pheromones from the bed bugs (5)[B].

Risk Factors

  • Immunocompromise
  • High hotel turnover
  • Secondhand furniture in home

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Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bed Bugs ID - 816286 ED - Baldor,Robert A, ED - Domino,Frank J, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816286/all/Bed_Bugs PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -