title: Bed bugs reproductive life cycle in the clothes of a patient suffering from Alzheimer's disease results in iron deficiency anemia.
abstract: We report the case of an 82-year-old patient, hospitalized for malaise. Her clothes were infested by numerous insects and the entomological analysis identified them as being Cimex lectularius (bed bugs). The history of the patient highlighted severe cognitive impairment. The biological assessment initially showed a profound microcytic, aregenerative, iron deficiency anemia. A vitamin B12 deficiency due to pernicious anemia (positive intrinsic factor antibodies) was also highlighted, but this was not enough to explain the anemia without macrocytosis. Laboratory tests, endoscopy and a CT scan eliminated a tumor etiology responsible for occult bleeding. The patient had a mild itchy rash which was linked to the massive colonization by the bed bugs. The C. lectularius bite is most often considered benign because it is not a vector of infectious agents. Far from trivial, a massive human colonization by bed bugs may cause such a hematic depletion that severe microcytic anemia may result.
authors.affiliation: Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, 1-3 rue Koeberlé, 67000 Strasbourg, France.
authors.forename: Marcela
authors.initials: M
authors.lastname: Sabou
authors.forename: Delphine Gallo
authors.initials: DG
authors.lastname: Imperiale
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Andrès
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abou-Bacar
authors.forename: Jacinthe
authors.initials: J
authors.lastname: Foeglé
authors.forename: Thierry
authors.initials: T
authors.lastname: Lavigne
authors.forename: Georges
authors.initials: G
authors.lastname: Kaltenbach
authors.forename: Ermanno
authors.initials: E
authors.lastname: Candolfi
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000209:etiology*; D000752:Anemia, Pernicious / Q000150:complications; D000818:Animals; D001511:Bedbugs / Q000502:physiology*; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications* / Q000469:parasitology; D007300:Insect Control / Q000379:methods; D007501:Iron / Q000627:therapeutic use; D012934:Social Isolation; D014131:Trace Elements / Q000627:therapeutic use; D014805:Vitamin B 12 / Q000627:therapeutic use; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D014131:Trace Elements; D014803:Vitamin B Complex; D007501:Iron; D014805:Vitamin B 12