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  • Tales from the Clinic




Bed Bugs
Aug 4th, 2010 Tales from the Clinic

An 11-year old boy is brought to clinic by his father for a rash that the child developed three days ago. Dad noticed a few red bumps on the child’s arms, and he now has several on his face and legs. “They itch a little, but not too much,” the child says. No one else in the household has this rash. The child has otherwise been well. No cough, fever, sore throat, vomiting or diarrhea. He hasn’t used any new soaps, detergents, or clothing and has not eaten any unusual foods. He spent the night at a friend’s house a few nights ago but since has been sleeping in his own bed.

On exam, the child is well appearing. He has several small pink fluid-filled bumps on his arms and forehead in clusters, and also has a few larger pink “welts” on his right arm and left neck. The areas are not warm or tender to touch.

Discussion
This patient appeared to have bedbug bites. Bedbugs are tiny insects that feed on human and animal blood. They like to hide in sheets and mattresses during the day and come out at night when they feed. They can live for up to 10 months and can go weeks between feedings.

There’s been a resurgence of bedbugs in the United States over the past few years. They are most often found in hotels, shelters, and apartment buildings. They can enter your home in luggage, clothing, boxes, pillows, and don’t always hang out in your bedding. They can also hide in furniture, wood, and trash.

Bedbugs don’t spread disease but can be a nuisance. Some people, if bitten, don’t experience much of a reaction at all, but others can develop intense itching and an allergic response. The bites usually appear as small red bumps that often occur in a linear pattern but can grow into large red welts in some people.

To find out whether you have bedbugs in your home, look for the tiny white or brown-colored bugs in the seams of mattresses. Or check for tiny bloodstains or insect waste on the sheets.

To get rid of them, you need to clean your home thoroughly. Wash all bedding and clothing in hot water and vacuum all carpets and cracks in wood floors. Get rid of infested mattresses and box springs and consider using an insecticide. You can check with a hardware or pest control company for further advice.

If bites begin to look infected with increased redness, warmth, and tenderness, you should see your doctor right away.

Follow-up
The patient’s father was given advice on how to look for bedbugs in his home. Benadryl and an over-the-counter hydrocortisone cream were recommended for itching.  More information



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