General Illness Information
INSECT BITES AND STINGS
Common Name: None Specified
Skin eruptions, swelling and other symptoms caused by insect bites or stings. Insects affect man by being pests, inoculating poison, invading tissue, or transmitting disease. Inoculation of poison may occur as either a bite or a sting. The bites cause a variety of reactions from a small bump to large sores (ulcers) with swelling and pain. The most severe reactions occur in people who are allergic to the bites or who develop an infection after being bitten. Insect bites can be fatal for those who are allergic to it.
Bites or stings from mosquitoes, fleas, black-flies, bedbugs, ants, spiders, bees, scorpions and other insects.
- After identifying the cause, remove it if possible. Treat animals for fleas and exterminate the house or kennel;
- If you cannot avoid exposure, apply insect repellents with diethyltoluamide (DEET)( less than 30%);
- Wear protective clothing;
- Prescribe anaphylactic (ANA kit) or Epi-Pen, if indicated;
- Consider desensitization with immunotherapy in severe cases;
- Permethrin applied to clothes is better against ticks than DEET.
Signs & Symptoms
- Red lump in the skin. The lumps usually appear within minutes after the bite or sting, but some don’t appear for 6 to 12 hours;
- A toxic reaction with pain, such as from bee stings;
- A toxic reaction with itching due to the body’s release of histamine at the bite site, such as from mosquitoes and black-flies.
- Nausea or vomiting;
- Itching eyes;
- Facial flushing;
- Dry cough;
- Chest/throat constriction.
- Areas with heavy insect infestations;
- Warm weather in spring and summer;
- Lack of protective measures;
- Perfumes, colognes;
- Previous sensitization.
Diagnosis & Treatment
- First-aid measures and emergency services in severe reactions;
- Remove stinger (scrape it out. Don’t use tweezers);
- For ant bites rub bite with ammonia; repeat as often as necessary;
- For spider or scorpion bites, capture the insect if possible, and seek medical attention.For ticks apply a petroleum product until the tick withdraws or slowly remove it with a pair of tweezers.
- The ticks head which may not come out with the body should be removed because it can cause prolonged inflammation or penetrate into deeper tissues.For mite infestations apply a cream containing permethrin or a solution of lindane. After treatment with permethrin or lindane, apply a corticosteroid cream to reduce itching until all mites are gone;
- Clean wound. Apply ice pack;
- Use immersion or wrapped soaks to relieve itching and hasten healing. Warm-water soaks are usually more soothing for pain or inflammation. Cool-water soaks feel better for itching;
- If you have had anaphylaxis (severe allergic reaction) following an insect bite, carry an anaphylaxis kit ( containing antihistamine tablets and a preloaded syringe of epinephrine) to treat it in the future.
For severe reactions:
- Adequate airway (intubation, tracheostomy) – if needed to bypass obstruction;
- Oxygen (4-6 L/min) – if needed for respiratory distress;
- Hospitalize and observe 24-48 hours.
Optimal treatment of necrotic spider bites is not well defined. Surgical repair may be required of severe ulcerative lesions. Individuals with known sensitivity should wear medical identification (bracelet, tag) or carry a card and should carry emergency allergy kit (epi-pen).
For minor discomfort, you may use:
- Non-prescription oral antihistamines to decrease itching;
- Non-prescription topical steroid preparations to reduce inflammation and decrease itching. Use according to label directions. For face and groin, use only low-potency steroid products without fluorine.
For serious symptoms, you may be prescribed:
- Stronger topical steroids or oral steroids if the reaction is severe;
- Injection of epinephrine or cortisone to prevent or diminish anaphylaxis symptoms;
- Tetanus prophylaxis if needed.
Rest to limit spread of poison.
No special diet.
- Secondary bacterial infection at the site of the bite;
- Anaphylaxis (life-threatening allergic reaction for hypersensitive persons);
- Arthropod associated diseases with tick, fly, bug and mosquito bites, e.g., lyme borreliosis, rickettsial disease (Rocky Mountain spotted fever), arboviral encephalitis, malaria, leishmaniasis, trypanosomiasis, dengue
Most troublesome symptoms disappear in 2 to 3 days, but scratching may prolong symptoms for several weeks. Treatment helps, but it doesn’t cure quickly.
Posted by RxMed