Severe allergy to bedbug bites — what to do? - briefly
If a severe allergic response occurs, use a prescribed epinephrine auto‑injector and call emergency services immediately. After stabilization, see a dermatologist or allergist for antihistamines or corticosteroids and arrange professional pest control to eradicate the insects.
Severe allergy to bedbug bites — what to do? - in detail
A severe allergic response to bedbug bites manifests as extensive swelling, hives, blistering, or systemic symptoms such as difficulty breathing, rapid heartbeat, and dizziness. Immediate assessment should focus on airway patency, breathing efficiency, and circulatory stability.
If respiratory distress or hypotension occurs, administer epinephrine intramuscularly at a dose of 0.3 mg for adults (0.15 mg for children) and call emergency services without delay. For less critical presentations, oral or injectable antihistamines (e.g., cetirizine 10 mg, diphenhydramine 25–50 mg) can reduce itching and cutaneous inflammation. Short courses of systemic corticosteroids (e.g., prednisone 40–60 mg daily for 3–5 days) may be prescribed to suppress prolonged immune activation.
Diagnostic confirmation involves skin-prick or intradermal testing with bedbug saliva extracts, complemented by specific IgE assays when available. Referral to an allergist ensures accurate identification of the allergen and formulation of a personalized action plan, including a written emergency protocol and prescription of an auto‑injector.
Long‑term management requires eradication of the infestation. Effective measures include:
- Reducing clutter to eliminate hiding places.
- Laundering bedding and clothing at ≥60 °C, followed by drying on high heat.
- Vacuuming mattresses, furniture, and floors, then discarding vacuum bags.
- Applying approved insecticide sprays or dusts to cracks, baseboards, and furniture frames.
- Enclosing mattresses and box springs in certified encasements.
Periodic inspections by professional pest‑control operators verify the success of remediation efforts. Patients with documented severe reactions should carry an epinephrine auto‑injector at all times and educate household members on its use. Regular follow‑up appointments allow adjustment of medication dosages and reassessment of environmental control strategies.