Complications
Anaphylaxis in response to bed bug bites is rare but has been reported.[3][22][38]
Typically presents with widespread urticarial rash, wheezing, inspiratory stridor, and hypotension.
Securing the airway and initiating prompt treatment with adrenaline is essential with supportive care (supplemental oxygen and intravenous fluids).
Several cases of iron deficiency anaemia caused by large infestations of bed bugs have been reported.[27][28]
One 2021 study on accident and emergency department patients from 2011 to 2017 found that patients bitten by bed bugs had lower haemoglobin, haematocrit, red blood cell, and mean corpuscular haemoglobin concentration values than non-bitten control patients, and were more likely to be anaemic or have severe anaemia.[28]
Laboratory evaluation is not part of the routine work-up for bed bugs and should only be considered if there is clinical suspicion of anaemia. If anaemia is found, treatment with iron supplements may be necessary.
Mental health sequelae ranging from general psychological symptoms (e.g., irritation and fatigue) to serious psychiatric manifestations (e.g., suicidal behaviour) have been attributed to bed bug infestations.[11][39] However, the majority of evidence is anecdotal.[11][39]
If psychological implications of bed bug infestation are suspected, assessment and treatment of these conditions may be necessary.
Bed bugs may be theoretical vectors for a variety of human pathogens, including Chagas disease in endemic areas, hepatitis B virus (HBV) infection, and HIV infection.[3][6][33]
However, the likelihood of bed bugs being a true vector of such disease is low. Most data suggest that bed bugs do not transmit HBV or are inefficient vectors.[3][12][40][41] There are few data to suggest any risk for Chagas disease or HIV infection.[3]
There is growing concern that bed bugs carrying MRSA or vancomycin-resistant enterococcus could be a vector for transmission of these infections.[42] One study demonstrated that bed bugs were able to transmit MRSA from a contaminated membrane to an uncontaminated membrane under experimental conditions.[43] However, further research is needed.
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