Systemic illness with eosinophilia and urticaria-like rash caused by prolonged bedbug exposure

Bedbugs are blood-feeding nocturnal ectoparasites, which are well-adapted to human habitats. In recent decades, bedbug infestation has been an emerging health problem worldwide, affecting all socio-economic population strata. The clinical presentations of bedbug exposure are variable, ranging from simple pruriginous bite lesions to severe cutaneous and systemic manifestations. Diagnosis is challenging and depends on awareness, clinical experience, and a thorough medical history. In our case, cutaneous lesions were accompanied by severe systemic symptoms and hypereosinophilia, leading to prolonged illness and hospitalization. The differential diagnosis of such presentations should include bedbug exposure, to avoid long-lasting disease, unnecessary diagnostic procedures, and the associated psychological burden for the patient.