Cimex lectularius (bedbug)
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Introduction
Reddish-brown flattened wingless insects approximately 5 mm in length. They are blood-sucking with long, narrow proboscis folded underneath the body when not in use.
* image[6]
Epidemiology
- cosmopolitan in distribution
- attack almost any mammal
- feed primarily at night
- during the day, they hide under mattresses or in other small dark spaces
- traveler's may unwittingly bring bedbugs home in their luggage
- permethrin resistant organisms found in New York City[2]
Pathology
- bedbugs are not known to transmit diseases
Genetics
- mutations in the voltage-sensitive Na+ channel alpha subunit gene are associated with resistance to permethrin[2]
Clinical manifestations
- generally painless, pruritic, urticaria-like papules with a central hemorrhagic punctum
- lesions in close configuration or linear distribution on exposed surfaces
- bites may cause painful wheal or bullae, depending upon the victim's sensitivity to the bedbug saliva
- some individuals may not react at all[2]
- bites generally rocognized in the morning because bedbugs feed at night
Complications
- bites can become secondarily infected
Management
- bedbugs do not actively infest skin, thus pediculocides such as permethrin are not indicated[3]
- topical glucocorticoids, unless secondarily infected
- oral antihistamines may provide symptomatic relief of itching[2]
- lesions are self limiting so treatment is not mandatory[3]
- eradication of environmental bedbugs best done by professionals
More general terms
References
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1303
- ↑ 2.0 2.1 2.2 2.3 2.4 Yoon KS et al Biochemical and molecular analysis of deltamethrin resistance in the common bed bug (Hemiptera: Cimicidae). J Med Entomol 2008 Nov; 45:1092. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19058634
- ↑ 3.0 3.1 3.2 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17 American College of Physicians, Philadelphia 2009, 2012, 2015
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ Goddard J, deShazo R. Bed bugs (Cimex lectularius) and clinical consequences of their bites. JAMA. 2009 Apr 1;301(13):1358-66 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19336711
- ↑ Kolb A, Needham GR, Neyman KM, High WA. Bedbugs. Dermatol Ther. 2009 Jul-Aug;22(4):347-52 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19580578
- ↑ 6.0 6.1 6.2 Bedbugs (image of bite mark) American Academy of Dermatology https://www.aad.org/public/diseases/itchy-skin/bedbugs
- ↑ 7.0 7.1 Burns DO 7 Bug Bites You Need to Know (image of bedbug) Medscape. June 17, 2021 https://reference.medscape.com/slideshow/bug-bites-6004328