Diagnosing Bed Bugs: A San Francisco HIV Clinical Dermatologist Dispenses Advice

Erin Amerson, M.D. (Credit: UCSF)
Erin Amerson, M.D.

At a recent presentation during HIV Grand Rounds at San Francisco General Hospital, Erin Amerson, M.D., asked, "How many in this room have seen bed bugs in your patients?"

The majority of the treating physicians in the room raised their hands, as Amerson guessed, "I'm sure most of you."

In San Francisco, Amerson has seen evidence of a bed bug epidemic. Many of her HIV patients at San Francisco General Hospital live in densely populated areas of the city and in large apartment complexes. "Once one apartment has bed bugs, the whole building has it. They're very challenging to get rid of, and it's a huge problem."

Bed bugs -- parasitic insects that bite humans to feed on their blood -- are not known to transmit disease but their bites can produce itchy red skin welts, allergic symptoms and other skin rashes.

According to Amerson, bed bug welts can be distinguished from other skin conditions because they appear in groups of three or four. "We call this, 'breakfast, lunch and dinner.' [One] bed bug will bite, move a few steps, bite again, move a few steps, and then when they are full -- usually after three or four bites -- they fall off."

For people with HIV or other people with compromised immune systems, skin reactions to bed bug bites can get inflamed -- even growing to "huge, fluid-filled blisters," Amerson explained.

"We see more robust bites in our HIV patients or patients with bone marrow transplants," she said.

This excerpt was cross-posted with the permission of BETAblog.org. Read the full article.