teaching doctors to diagnose bed bug bites

by nobugsonme on February 24, 2007 · 18 comments

in bed bugs, bedbugs, health, misdiagnoses

Many of us went to doctors (both internal medicine specialists and dermatologists) with our bed bug bites and were misdiagnosed. Some people are wrongly told they have scabies and treated for it (as I was, without the doctor having done a simple scraping to diagnose a scabies infestation.) People are sometimes even told they have delusional parasitosis. Parakeets has long recommended seeing a doctor who was educated overseas, since they can often spot bed bug bites. But my dermatologist was from the Middle East, and couldn’t.

But it’s important to note that our bites don’t all look the same. You won’t believe how many people (doctors, PCOs, even friends who had read the articles and seen the TV news segments) saw my bites and said, “those aren’t bed bug bites,” because they did not look like this or this. Mine mostly looked like these bites on Caryn’s leg (only the ones on her leg), but some were like mosquito bites of various sizes.

Thankfully, WebMD’s site on bed bugs quotes Harvard Entomologist Michael Pollack sets the record straight:

Forget everything you’ve heard about being able to tell the biter was a bed bug by looking at a bite. “I feed all kinds of bloodsuckers on my body, and in the vast majority of cases you can’t look at a mark and tell what made it,” says Pollack. “I recently gave a talk to physicians and quizzed them on pictures of bites, and their batting average was zero. The bites resemble those of other blood-feeding insects, such as mosquitoes, fleas, biting gnats, or mites.”

I’m envisioning a website full of comparisons between bed bug bites on various entomologists, who have to feed their bed bug colonies. (If you’ve watched enough news segments, you’ve seen several of them doing so.)

And yay, Pollack spoke to doctors about how to recognize the bites. Perhaps its better going to a doc now than it was last year. I am sure there’s more to be done, but everything helps. What also helps, in a small way, is when we go back and tell the doctors who insisted that those were not bed bug bites that, yeah, they were.

This snippet describes a conference presentation on bed bug bites. It is unclear whether this has already taken place, but I share it because the need for doctors to be more aware of how bed bug bites appear on patients is something many of us are concerned about.

“Resurgence of Bedbug Bites Misdiagnosed as Allergic Skin Rashes in Inner-City Population.” (Abstract #P199: Nov. 11-12, Noon – 1:00 p.m.) – Sreenivasrao Amara, M.D., et al, Brooklyn, N.Y. – There is an increase in reports of bites from bedbugs (Cimex lectularius), a nocturnal bloodsucking parasite, in the U.S. and worldwide. Investigators report six patients with multiple, cutaneous manifestations misdiagnosed as allergic reactions that were proven bedbug bites. They recommend health care professionals be alert to screen for bedbug bites in any patient with a new refractory rash.

I’m a bit perplexed, since I understood that bed bug bites were an allergic reaction to bed bugs. In any case, it’s good word is getting around that people may present with bed bug bites, and those may look different depending on the person (and even different on the same person from bite to bite).

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1 Caryn February 24, 2007 at 9:15 am

Maybe that’s a reason for more people to take pictures of their bites? So we can see all the different ways they show up?

By the time one gets to a doctor, the bites may have healed somewhat and harder to recognize.

When I went to a doctor in 2004, she definitely didn’t recognize them as bedbugs bites. She did think they were insect bites of some kind though.

And those bites on my leg in the picture? It was a long time ago, but I’d bet a lot of that was my own doing — in some places, like that, I’d scratch so much that I’d break the skin. :( This time, I’ve been good with the hydrocortisone, which works like a charm!

2 strangedays February 24, 2007 at 12:13 pm

This is a different take on The Beatles song Blackbird

Bedbugs creepin’ in the middle of the nite..
They ain’t got no wings, but they sure bite..
all your life
you were only waiting for these monsters tooo die

bedbugs die
bedbugs die
and in the mornin’ nomore bedbug bites
Strangedays, indeed…

3 strangedays February 24, 2007 at 12:14 pm

sorry, wrong thread?

4 nobugsonme February 24, 2007 at 12:44 pm

HI SD,
It’s good to post the “general” stuff along with the Q&A, updates, etc. in the “Tales of Woe” discussion, but it’s totally okay that you posted this here. We just try to keep it on topic as much as possible because if we don’t, we end up having several parallel conversations in several threads at once.

5 strangedays February 24, 2007 at 1:09 pm

Gotcha. I’m not the best at understanding these forums even when I have regular, solid sleep.
Next time, before I hit submit, I will make sure where I am.
Sorry, folks.
S/ds

6 nobugsonme February 24, 2007 at 1:18 pm

No worries, SD, seriously!
The structure of this site is kind of not what I want it to be, but I can’t change it until I move it off wordpress and host it myself, so this is the patched-together solution. It’s the site that has issues, the readers are not faulty. Remember that! :-)

7 nichole August 22, 2008 at 6:15 pm

exactly how long do bed bug bites last on the skin

8 Megs September 26, 2008 at 10:40 am

When I went to the emergency room a few weeks back, I was misdiagnosed with Chicken Pox, even though I explained to the doctor that I’d had chicken pox when I was young. I’d told him my bed bug theory, and he just kept insisting “those are not insect bites! THIS is an insect bite!” and pointing to a mosquito bite on my leg, no matter how I insisted that mosquitos were a totally different insect.

9 nobugsonme September 26, 2008 at 11:33 am

Megs,

Sadly, your story is not uncommon. Bed bug bites look different on different people (or even on the same people), so it is understandable that doctors can’t identify them on sight. Sadly, many of them do not know this, and it’s amazing how they will hand out diagnoses of other conditions, even apparently extremely unlikely ones as in your case.

However, there is a need for doctors to be educated about bed bug bites, the range of appearances they may have, and their prevalence today.

10 Jennifer Riggin October 13, 2008 at 1:57 am

I have been to something like 5 or 6 doctors, from gynecologists to dermatologists, hospitals and regular doctors in New York city and it is horrible. Because of my work, it is important that these bites get dealt with. Instead I am treated like I am the problem and I have been prescribed everything from penicillin to antibiotics. Nothing which has helped. I am at my wits end cause I want to work, but my butt is permanently scarred it may seem at this point. So frustrating.

11 Doug Summers MS October 13, 2008 at 6:21 pm

Jennifer
You might want to consider hiring an experienced K9 team to screen for bed bugs to confirm or rule them out.

The key is to identify the pest directly, it is very hard to determine the source of the bite from the appearance of the wound in many cases.

12 nobugsonme October 13, 2008 at 6:38 pm

Jennifer,

Has the doctor ruled out other problems (folliculitis? scabies?)

You need to positively determine whether bed bugs are the problem. Doug is in the k9 bed bug detection business, and he is right that a bed bug k9 is an option.

Another option is trying to find an experienced, knowledgeable PCO to inspect. Users in our forums might have suggestions.

Talk to your landlord/attached neighbors. Keep in mind experts say as many as 70% of people may not react to bed bug bites. Neighbors may not see bugs either. I would not discount the possibility of bed bugs coming from next door, or biting you at work, friends’ homes, or other places you frequent.

If you want to discuss this further, please come to the forums:

http://bedbugger.com/forum/

13 Sara December 1, 2008 at 2:30 pm

Is anyone aware of guidelines for physicians’ offices on how to properly sanitize after a patient has come in with bed bugs?
thanks

14 nobugsonme December 2, 2008 at 1:54 am

Did they have bed bugs on them, that you saw? Or did they simply have bites (obtained at home, etc.) with no evidence of bed bugs?

In any case, by the time you read this, if there were actual bugs sighted, it could be quite bad. They may have moved around. I’d get a pest control professional in to inspect right away, perhaps with a reputable bed bug sniffing k9 to determine the locations of harborages. Steam can be used if pesticides are an issue, or (more effectively thermal heat) but you should act quickly.

Please come to the forums if you want to discuss this further, and please call a pest control pro who KNOWS bed bugs right away. Not only can they help you deal with this instance, but a good one (with consulting entomologist) can help you make a plan to prevent and monitor for future problems.

15 Lisha April 9, 2010 at 1:59 pm

Is there anything a doctor can do for bed bug bites or do you just have to wait for them to go away?

16 Strabat April 19, 2010 at 12:32 am

Lisha,
This may or may not be helpful. It is showing promise for wound healing.

http://web.mit.edu/newsoffice/2010/itw-haiti-0414.html

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