- Dirk M Elston, MD
Dirk M Elston, MD
- Professor and Chair, Department of Dermatology and Dermatologic Surgery
- Medical University of South Carolina
- Stephen Kells, PhD
Stephen Kells, PhD
- Associate Professor of Entomology
- University of Minnesota
- Section Editors
- Robert P Dellavalle, MD, PhD, MSPH
Robert P Dellavalle, MD, PhD, MSPH
- Section Editor — General Dermatology
- Professor of Dermatology and Public Health
- University of Colorado School of Medicine
- Colorado School of Public Health
- Chief, Dermatology Service
- US Department of Veterans Affairs
- Eastern Colorado Health Care System
- Ted Rosen, MD
Ted Rosen, MD
- Section Editor — Infections and Infestations
- Professor, Department of Dermatology
- Baylor College of Medicine
Bedbugs are obligate, blood-feeding insects that infest human dwellings and inflict bites that can cause local skin reactions in humans (picture 1A-E). Management involves confirmation and eradication of the infestation. Antipruritic agents and psychologic support for victims also may be needed.
The clinical features, diagnosis, and management of bedbug infestations will be reviewed here.
Bedbugs (also written as "bed bugs") are true bugs of the order Hemiptera and family Cimicidae. Cimicids commonly infest human, bird, and bat habitats. As parasites, cimicids are unique because they are obligate blood feeders but do not remain on the host to complete their life cycle. Rather, they hide in the surrounding habitat. Cimex lectularius and Cimex hemipterus are the two bedbug species that most commonly affect humans. (See 'Life cycle' below.)
Correct identification of bedbugs is important for implementing proper control measures. Bat bugs (Cimex adjunctus and other species) and swallow bugs (Oeciacus vicarius) are other members of the Cimicidae family that may be mistaken for bedbugs and may incidentally bite humans (picture 2).
Bedbugs have flat, red-brown, oval bodies and are similar in size to a dog tick (picture 1A). The eyes are widely separated, and the mouthparts are retroverted with the labium slender and elongated, forming a three-segmented rostellum (rostrum). The wings are reduced to hemelytral pads, with membranous hindwings vestigial or absent. The pronotum (a plate-like structure covering the dorsal thorax) has a concave anterior margin where it connects to the head. Bristles project laterally along the margins of the pronotum, starting behind the eye and continuing along the lateral edge (picture 2). Bristles can also be present on the dorsal surface. The antennae have four segments, with the distal three segments long and slender. The abdomen has eleven segments that expand during feeding, exposing intersegmental membranes.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- LIFE CYCLE
- CLINICAL MANIFESTATIONS
- Skin reactions
- When to suspect bedbug infestation
- Confirming the diagnosis
- DIFFERENTIAL DIAGNOSIS
- Treatment of bites
- Psychologic support
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS