Bedbug infestation.

The significant resurgence of bedbugs in the past decade has been attributed to pesticide resistance, more frequent travel, lack of public awareness, and inadequate pest control programs. Bedbugs are obligate blood parasites (insect family Cimicidae). They can withstand a large range of temperatures but are attracted to warmth and carbon dioxide. They typically feed just before dawn. Cutaneous reactions to bedbug bites can include macules, papules, wheals, vesicles, bullae, and nodules. Bites may be confused with other skin conditions. Bedbug bite reactions are typically self-limited and resolve within one to two weeks without treatment. Bedbug infestation may cause significant psychological distress. The diagnosis of a bedbug infestation is based on history, appearance of bites, and inspection of sleeping quarters. Although there is no evidence that bedbugs transmit disease, systemic reactions may include asthma, angioedema, generalized urticaria, iron deficiency anemia, and, rarely, anaphylaxis. An integrated pest management strategy should be employed to eliminate infestation. Tactics include vacuuming, heat or cold treatment, trapping devices, and pesticides.