Distinguishing between bites
Bedbugs: A rash with multiple exposures on skin that is often not covered by clothing is typical of fleas or bedbugs in a house. Other members of the family may not have it. Bedbugs tend to bite on the upper body and neck.
Flea bites are usually at ankle height because fleas jump. Flees are wingless. Flea bites may transmit plague, tularemia, cat-scratch disease, and cat flea typhus (Rickettsia felis).
Tick bites – You either see an actively feeding insect or a single papular lesion caused by a tick bite. Lyme disease tick bites are localized and don’t itch.
Brown recluse spider bites – Is usually a single bite. It’s not expected to be recurrent or be in multiple places. May cause skin necrosis. “Most recluse bites resolve uneventfully without aggressive therapy and require only wound care and minor debridement.”
Black widow spiders (Latrodectus) – a single bite that causes intense muscle spasms. Treat with narcotics, benzodiazepines, or, when necessary, antivenom.
Mite/chigger – A chigger is the larval form of a mite. The larval tends to crawl “into spaces near constricted clothing and cause welts from their bites along the neckline, waistline, sock line, or more rarely on the genitals.” “The chiggers crawl on skin until they reach constrictive clothing like belts or socks and then bite there.”
Scabies – present as an eczematous rash in folds of skin such as in the web spaces of fingers, the umbilicus, the axillae, or the genital region. There is borrowing and signs of deeper inflammation. Very itchy.
Mosquito bites would be diffuse on exposed areas.
Further Reading / References
Common cutaneous parasites. Ann Intern Med 2014;161(5).
BMJ 2013;346:f138. Bed bug infestation.
Arthropod bites. Am Fam Physician 2013;88(12):841-847.