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Bed Bugs

Fawn Winkelman, DO and Adam Strosberg, DNP, ARNP-BC Reviewed 06/2018
 


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...

DIAGNOSIS

HISTORY

  • Recent travel

  • Bed bug sighting; blood specks on sheets

  • New skin lesions in the morning

  • Intense pruritus, pain, or burning

PHYSICAL EXAM

  • Characteristic lesions are erythematous pruritic pap...

TREATMENT

GENERAL MEASURES

  • Self-limited and resolves within 1 to 2 weeks

  • Treat symptomatically.

  • Avoid and control bed bugs.

MEDICATION

First Line

  • Disease is self-limited; treat symptoms.

  • Oral antihistamines ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Not necessary as disease is self-limited

  • May need specific care in extreme cases or if anaphylactoid reactions

PATIENT EDUCATION

  • Avoid scratching to prevent superinf...

REFERENCES

1
1 Studdiford JS, Conniff KM, Trayes KP, et al. Bedbug infestation. Am Fam Physician.  2012;86(7):653–658. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 Williams K, Willis MS. Be...

ADDITIONAL READING

CODES

ICD10

  • S00.96XA Insect bite (nonvenomous) of unspecified part of head, initial encounter

  • S10.96XA Insect bite of unspecified part of neck, initial encounter

  • S40.269A Insect bite (nonvenomous) of uns...

CLINICAL PEARLS

  • 90% of infestations occur within 3 feet of beds.

  • Wash bedding/clothing regularly in hot water and vacuum carpet daily or steam clean daily.

  • Inspect furniture, bedding, and luggage regula...

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