Bed bugs - What the GP needs to know.

BACKGROUND Since the mid 1990s, there has been a global resurgence of bed bugs (Cimex spp.), which are blood feeding insects that readily bite humans. Patients suffering with bite reactions are increasingly presenting to medical practitioners. OBJECTIVE This article reviews the various clinical consequences of bed bug bites and outlines management strategies. DISCUSSION Common dermatological responses include the early development of small macular spots that may later progress into prominent wheals accompanied by intense itching. Patients exposed to numerous bed bugs can present with a widespread erythematous rash or urticaria. Bullous eruptions are not uncommon and anaphylaxis has been reported, albeit rarely. There is no evidence that bed bugs transmit human pathogens, but they are responsible for significant psychological distress, can produce anaemia when abundant, and have been implicated in the triggering of asthmatic reactions. Symptomatic control involves treatment of the patient with antihistamines and corticosteroids, and ensuring that the infestation responsible for the problem is effectively eliminated.