Bed Bugs Can Cause Bed Shortages

1Cleveland Clinic, Cleveland, OH

Meeting: Hospital Medicine 2011, May 10-13, Dallas, Texas.

Abstract number: 235

Case Presentation:

A 58‐year‐old man with a medical history of chronic obstructive pulmonary disease (COPD) came to the emergency department (ED) with complaints of worsening cough and shortness of breath and was admitted for COPD exacerbation. He was unemployed and had a significant smoking and alcohol history. He also complained of itching over most of his body, and small insects were noted on his foot and multiple others in his socks. These were identified as bed bugs by an experienced microbiology technician. The patient was quarantined to an isolation room. The caregivers wore special protective clothing while visiting his room. He was instructed to take a shower and was treated symptomatically with an antihistaminic for his pruritus and steroids and nebulizers for COPD. He was given a clean set of clothes and shifted to a regular room. The room was treated with pest control. Subsequently, it was found that a few beds in the observation area in ED had to be closed down because of suspicion of bedbug infestation.

Discussion:

Bedbugs are a growing annoyance in most U.S. cities. Bedbugs have flat oval bodies and are reddish brown in color. Bedbugs often feed while the victim sleeps, with most feeding done just before dawn. The bites are often present in rows on exposed areas of the body like the face, neck, hands, and arms. The bites are frequently pruritic, but some patients have asymptomatic pur‐puric macules. Bedbug infestation is difficult to diagnose and should be suspected if specks of blood containing dung are found on linens and mattresses. There was concern about bedbugs acting as vectors for hepatitis B and C and trypanosomiasis, but the evidence is not convincing. The bites do not require treatment, and symptoms are controlled with topical steroids and antihistaminics. They cause significant psychosocial stress in the community. Bedbug infestation in a hospital is a major problem with no clear guidelines. Just the suspicion of bedbugs leads to significant disruption in hospitals, causing sealing of a large number of hospital rooms, disposal of furniture and mattresses, expenses related to fumigation, and other pest control treatment. They cause significant anxiety in patients and care‐givers and invariably get bad publicity for the affected hospital in the news. Most often the creature in question is not a bedbug, and it is prudent to send the creature to the laboratory for confirmation. The patient's clothing should be double‐bagged in plastic and handed over to family. Washing and drying the clothes at maximum temperature is enough to kill any residual bedbugs. Notify the environmental services department so they can arrange to monitor the room and arrange for extermination services if necessary.

Conclusions:

Bedbug infestations are increasing and seen more frequently in the hospital, causing a significant shortage of beds. Management starts with identification of the bug and seeking help from experienced pest control professionals. Bedbugs do not cause infection, but they can cause disruption of work flow and problems with throughput because of the associated fear of spreading the infestation

Disclosures:

R. Bahuva ‐ none; A. Satra ‐ none; S. Manda ‐ none; S. Suri ‐ none

To cite this abstract:

Bahuva R, Satra A, Manda S. Bed Bugs Can Cause Bed Shortages. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 235. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/bed-bugs-can-cause-bed-shortages/. Accessed May 22, 2019.

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