Killing bed bugs with steam iron1/3/2023 ![]() Testing of stool specimens for occult blood was negative on 3 occasions.Īt 6 months after treatment of his apartment, the patient’s anemia had not recurred. Six weeks later, his hemoglobin level was 146 g/L and his serum ferritin level was normal, at 57 μg/L. Four weeks after treatment of his apartment, the patient’s hemoglobin level was 132 g/L. The patient continued to take 300 mg of ferrous fumarate orally 3 times daily. His apartment was treated with insecticides by a pest control operator, and all infested furniture was removed. Because the patient lacked the capability to prepare his apartment for treatment of the infestation, public health authorities found temporary accommodation for him at a shelter. The physician hypothesized that the patient’s anemia was due to blood loss from bedbug bites. Inspection of the apartment revealed dozens of bedbugs crawling on the walls and thousands living within the patient’s mattress and bedding. His family physician noted several bedbugs crawling on the patient. The patient reported that he had hundreds of bedbugs in his apartment but had not made efforts to have the infestation treated. Shortly after discharge, the patient’s family physician conducted a home visit with the patient. The patient was discharged home with the diagnosis of iron-deficiency anemia of unknown cause. A computerized tomography scan of the abdomen and pelvis appeared normal. His hemoglobin level increased to 83 g/L. He was readmitted to hospital and given 3 units of red blood cells. Three weeks later, the patient’s hemoglobin level was 52 g/L. ![]() The patient was discharged home and instructed to continue the oral ferrous fumarate therapy. No abnormalities of the upper and lower gastrointestinal tracts were seen on gastroscopy and colonoscopy. After the patient received 2 units of red blood cells, his hemoglobin level rose to 77 g/L. Serum lactate dehydrogenase and total bilirubin levels were normal. The reticulocyte count was 5.3% (2.0% after correction for hemoglobin level). He was admitted to hospital, where his hemoglobin level was found to have dropped to 57 g/L. Four weeks later, he was seen again by his family physician and noted to be very pale. The patient was given a single dose of 1000 μg of vitamin B 12 intramuscularly. Therapy was started with ferrous fumarate, 300 mg orally twice daily, and folic acid, 5 mg orally once daily. Four months earlier, the patient’s hemoglobin level had been 147 g/L. Vitamin B 12, erythrocyte folate, creatinine and thyroid-stimulating hormone levels were normal. The serum ferritin level was 18 (normal 27–220) μg/L. The leukocyte count and differential were normal the platelet count was 428 (normal 150–400) × 10 9/L. Laboratory testing showed a hemoglobin level of 80 (normal 135–180) g/L, a mean corpuscular volume of 97.5 (normal 80–97) fL and nonspecific erythrocyte changes on the blood smear. Physical examination was otherwise unremarkable. There were numerous erythematous, excoriated papules and welts on his scalp and arms. #Killing bed bugs with steam iron skin#On examination, the patient’s skin showed no visible signs of bleeding. He reported a proliferation of bedbugs in his apartment beginning about 2 months before presentation. He lived alone, in an apartment building that had bedbug infestations. He had no history of cognitive impairment. #Killing bed bugs with steam iron crack#He used crack cocaine frequently and reported that he often skipped meals while taking crack cocaine. The patient had a history of alcohol abuse but had not been drinking for the past year. He was not taking acetylsalicylic acid or nonsteroidal anti-inflammatory drugs. His medications were metformin, glyburide, omeprazole, pravastatin, citalopram and olanzapine. ![]() The patient had type 2 diabetes, hypercholesterolemia, reflux esophagitis and depression. Upon questioning, he reported no bleeding from his gastrointestinal tract or other sites. ![]() A 60-year-old man presented to his family physician with a 2-month history of fatigue and lethargy. ![]()
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