Bed Bugs - Dr. Raper

​Bed Bugs
- Do not analyze a rash and simply call it bed bugs. There is a differential--includes scabies, fleas, bat bugs, dermatitis herpetiformis
- Bite mark: occasionally linear formation where bedbug makes its "path." usually on exposed skin. erythematous wheel with occasional bloody center
- 3/10 people bit will show NO symptoms. The skin changes that appear are an allergic reaction
- They DO NOT transmit disease. Hep B, Hep C, HIV-- die quickly within the bedbug gut
- They love warmth, dark and CO2. If bed bugs are seen in the well-lit ED, the patient likely has a MASSIVE infestation at home
- Hitchhikers: they latch onto anything. at the laundromat, the hotel, your scrubs...
- Oh not, not Diapause! Concept that bedbugs can remain without a meal for months and lie dormant. Even in cold as low as -12C. 
- Heat kills: Need 120 F for at least 30 minutes: kills all life forms. Dryer works. 
- Studies have shown "bug bombs" have no difference vs. controls
- Treatment for rash: supportive. Rash generally resolves within 7 days spontaneously. Can use antihistamines or topical steroids PRN. However, antihistamines can make it difficult to discern if rash is bed bugs
- Treatment at home: Combination of pest control, Heat, Sealing Cracks and Crevices, Treating Bed frames box springs and mattresses 
- Biopsy is of no use. 
...now go change your scrubs

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