New pandemic, old bugs: A case of cimicosis (Bed Bug) in a neglected elderly patient during the coronavirus disease quarantine

Abstract

Bed bugs are hematophagous arthropods that can parasitize humans. During the coronavirus disease pandemic, there has been an increase in elderly neglect. A man in his 90s came to the hospital complaining of generalized pruritus. Despite being a dependent patient, he was left alone in a home by his relatives during the pandemic. Examination revealed inflammatory nodules in addition to a live bed bug crawling over his trunk. Identifying a bed bug during consultation is an uncommon feature that can help determine a particular diagnosis. As this case shows, the need for social isolation during pandemics can contribute to elder abuse and neglect.

Bed bug (Cimex spp.) colonization of human host

“…Since a lack of sensation alone should not lead to bed bug colonization of human tissue, this finding in a patient lacking independence in activities of daily living raised the concern for potential elder neglect. 10 …”

Bed Bugs (Hemiptera, Cimicidae): A Global Challenge for Public Health and Control Management

“…During the coronavirus disease pandemic, there has been an increase in elderly neglect. Therefore, the need for social isolation during pandemics can contribute to elder abuse and neglect [ 18 ]. Nowadays, bed bug infestations are no longer limited to homes and hotels, and infestations have become common in private or public settings, including elder residences, healthcare facilities, and public transportation [ 19 , 20 ].…”

Bed bug (Cimex lectularius) infestation in a surgery ward from northeastern Brazil

“…To the best of our knowledge, no other similar nosocomial infestation has been reported in Brazil. Most publications focus on the dermatological aspects of individual cases and biological distribution (Criado et al, 2011;Delaunay, 2011;Dellatorre & Haddad, 2021). In Brazil, clinical data regarding bed bugs is very scarce.…”

“…Our suggestions in the face of a bed bug infestation are: 1) keep the patients' items in sealed plastic bags and/or frozen until the next day; 2) use mechanical methods such as steam cleaners in the patient's room, as well as the material in contact with the patients; 3) inspect wheelchairs, beds, door baseboards, and walls, and remove in the case of bed bugs; 4) alert the infection control commission for the implementation of control measures. Eradication is usually linked to early detection, and although chemical methods were also used, these methods are commonly unnecessary (Dellatorre & Haddad, 2021). If there is a high suspicion of a bed bug infestation, we recommend the inspection of rest areas, such as beds, sofas, and their surroundings, must be conducted meticulously, which often requires an experienced professional (Dellatorre & Haddad, 2021).…”

“…Eradication is usually linked to early detection, and although chemical methods were also used, these methods are commonly unnecessary (Dellatorre & Haddad, 2021). If there is a high suspicion of a bed bug infestation, we recommend the inspection of rest areas, such as beds, sofas, and their surroundings, must be conducted meticulously, which often requires an experienced professional (Dellatorre & Haddad, 2021). There are modern methods to detect bed bugs with attractant-based bed bug traps ("monitors" or "interceptors"), and they may be useful (Parola & Izri, 2020).…”