Bedbugs are resourceful and opportunistic insects. In one well-documented daytime outbreak, its victims were all women who rode a particular English tram. Each lady had a peculiar band of erythema studded with bullae on the back of both calves. Visual searching of beds for bedbugs may be useful. It may be more efficient to survey the corners of bednets and mattresses.
Bedbugs produce a peculiar pungent odor familiar to building inspectors and tenement dwellers.
With a heavy infestation, speck-like masses of dung may be evident behind wallpaper and at other sites. This dung contains blood elements. Confirming the diagnosis of a bedbug bite sometimes may be difficult. Take a detailed history of the home environment, work conditions, and domestic animals. The bites of the bed bug are painless, but pruritus and purpuric macules may appear.