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Bedbug - close-up
Bedbug - close-up


Black widow spider
Black widow spider


Body louse
Body louse


Flea
Flea


Fly
Fly


Kissing bug
Kissing bug


Dust mite
Dust mite


Mosquito, adult feeding on the skin
Mosquito, adult feeding on the skin


Wasp
Wasp


Insect stings and allergy
Insect stings and allergy


Brown recluse spider
Brown recluse spider


Black widow spider
Black widow spider


Stinger removal
Stinger removal


Flea bite - close-up
Flea bite - close-up


Insect bite reaction - close-up
Insect bite reaction - close-up


Insect bites on the legs
Insect bites on the legs


Head louse, male
Head louse, male


Head louse - female
Head louse - female


Head louse infestation - scalp
Head louse infestation - scalp


Lice, body with stool (Pediculus humanus)
Lice, body with stool (Pediculus humanus)


Body louse, female and larvae
Body louse, female and larvae


Crab louse, female
Crab louse, female


Pubic louse-male
Pubic louse-male


Head louse and pubic louse
Head louse and pubic louse


Brown recluse spider bite on the hand
Brown recluse spider bite on the hand


Insect bites and stings
Insect bites and stings


Definition:

Insect bites and stings can cause an immediate skin reaction. The bite from fire ants and the sting from bees, wasps, and hornets are usually painful. Bites caused by mosquitoes, fleas, and mites are more likely to cause itching than pain.



Alternative Names:

Bedbug bite; Bee sting; Bites - insects, bees, and spiders; Black widow spider bite; Brown recluse bite; Flea bite; Honey bee or hornet sting; Lice bites; Mite bite; Scorpion bite; Spider bite; Wasp sting; Yellow jacket sting



Considerations:

In most cases, bites and stings can be easily treated at home. However, some people have a severe allergic reaction to insect bites and stings. This is a life-threatening allergic reaction known as anaphylaxis , and it requires urgent emergency care. Severe reactions can affect the whole body and may occur very quickly, often within minutes. These severe reactions can be rapidly fatal if untreated. Call 911 if you are with someone who has trouble breathing or goes into shock .

Some spider bites, like those of the black widow or brown recluse, are also serious and can be life-threatening. Most spider bites, however, are harmless. If bitten by an insect or spider, bring it for identification if this can be done quickly and safely.



Causes:



Symptoms:

The non-emergency symptoms vary according to the type of insect and the individual. Most people have localized pain, redness, swelling, or itching. You may also feel burning, numbness, or tingling.



First Aid:

For emergencies (severe reactions):

  1. Check the person's airways and breathing. If necessary, call 911 and begin rescue breathing and CPR .
  2. Reassure the person. Try to keep him or her calm.
  3. Remove nearby rings and constricting items because the affected area may swell.
  4. Use the person's Epi-pen or other emergency kit, if they have one. (Some people who have serious insect reactions carry it with them.)
  5. If appropriate, treat the person for signs of shock . Remain with the person until medical help arrives.

General steps for most bites and stings:

  1. Remove the stinger if still present by scraping the back of a credit card or other straight-edged object across the stinger. Do not use tweezers -- these may squeeze the venom sac and increase the amount of venom released.
  2. Wash the site thoroughly with soap and water.
  3. Place ice (wrapped in a washcloth) on the site of the sting for 10 minutes and then off for 10 minutes. Repeat this process.
  4. If necessary, take an antihistamine, or apply creams that reduce itching.
  5. Over the next several days, watch for signs of infection (such as increasing redness, swelling, or pain).


Do Not:
  • Do NOT apply a tourniquet.
  • Do NOT give the person stimulants, aspirin, or other pain medication unless prescribed by the doctor.


Call immediately for emergency medical assistance if:

Call 911 if the person is having a severe reaction:

  • Trouble breathing, wheezing, shortness of breath
  • Swelling anywhere on the face
  • Throat feels tight
  • Feeling weak
  • Turning blue


Prevention:
  • Avoid provoking insects whenever possible.
  • Avoid rapid, jerky movements around insect hives or nests.
  • Avoid perfumes and floral-patterned or dark clothing.
  • Use appropriate insect repellants and protective clothing.
  • Use caution when eating outdoors, especially with sweetened beverages or in areas around garbage cans, which often attract bees.
  • For those who have a serious allergy to insect bites or stings, carry an emergency epinephrine kit (which requires a prescription). Friends and family should be taught how to use it if you have a reaction. Wear a medical ID bracelet.


References:

Goldman L, Ausiello D, eds. Cecil Textbook of Medicine, 22nd ed. Philadelphia, Pa: Saunders; 2004.

Noble J, Greene HL, Levinsen W, eds. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001.

Auerbach PS, ed. Wilderness Medicine. 4th ed. St. Louis, Mo: Mosby; 2001.




Review Date: 2/19/2008
Reviewed By: John E. Duldner, Jr., MD, MS, Assistant Professor of Emergency Medicine, Director of Research, Department of Emergency Medicine, Akron General Medical Center and Northeastern Ohio Universities College of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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