What’s biting you while you sleep?

THEY came up suddenly after the patient had visited a relation and slept on an old mattress.

These were florid bed bug bites. Bed bugs are becoming a problem in many cities of the world, even in rather expensive hotels. They occupy the crevices of the mattress or bed head and come out at night to feed.

The intensity of the reaction you get to the bite is related to how allergic you are to bed bugs rather than any toxicity of the bed bug saliva. A highly allergic patient like this needs some oral steroids at a dose of 50mg daily for a few days to settle this down. All the oedema here is in