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Bed Bugs

Fawn J. Winkelman, DO and Adam Strosberg, DNP, ARNP-BC Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Nocturnal obligate blood parasites residing in furniture and bedding

  • 5 to 7 mm oval, reddish brown, flat, wingless morphology

  • Microscopic evidence suggests a mature bed bug, Cimex lect...

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

  • Treatment should address three areas: treatment of the skin; eradication of the infestation; and assessment for potential mental health consequences (1).

  • Most patients present...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Not necessary as disease is self-limited

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

  • Consider behavioral health consultation depending on ...

REFERENCES

1
McNeil C, Jarrett A, Shreve M. Bed bugs: current treatment guidelines. J Nurs Pract.  2017;13(6):381–388.
2
Woloski JR, Burman D, Adebona O. Mite and bed bug infections. Prim Care. ...

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 bedding.

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

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

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