Chief Complaint: “I wake up every morning with itchy red spots on my skin.”

History of Present Illness:
A 32-year-old woman living in a crowded apartment complex presents to the clinic with multiple itchy red bumps on her arms, neck, and back. She first noticed the bites about three weeks ago and initially thought they were mosquito bites. However, the bites have been increasing daily, and she notices new ones every morning. The itching is intense, particularly at night, and over-the-counter antihistamines have provided little relief.

She recently moved into a furnished apartment and has not traveled recently. She denies any pets in her home but mentions seeing small reddish-brown insects on her mattress seams. No other family members have similar symptoms.

Physical Examination:

• Multiple small, red, itchy welts in clusters or linear patterns on exposed areas (arms, neck, back)
• No signs of secondary bacterial infection
• No fever or systemic symptoms

Diagnosis:
The patient’s history and the presence of grouped bites in a linear pattern strongly suggest bedbug infestation, caused by Cimex lectularius. Bedbug bites typically occur at night and are often arranged in a "breakfast, lunch, and dinner" pattern.

Management Plan:

• Symptomatic relief: Topical corticosteroids or oral antihistamines for itching
• Environmental control:
  • Wash all bedding and clothing in hot water
  • Vacuum and steam-clean mattresses, carpets, and furniture
  • Consider professional pest control services
• Patient education:
  • Avoid scratching to prevent secondary infection
  • Inspect luggage and furniture when traveling or moving into a new home

The patient is advised to monitor for new bites and seek follow-up care if symptoms worsen or signs of infection develop.