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Insect Bites and Stings

Summary

Insect bites and stings can cause reactions ranging from mild redness and swelling to severe allergic reactions, including anaphylaxis. Most bites and stings cause only temporary discomfort, but some can lead to serious complications.

  • Mild reactions include redness, itching, and swelling at the bite or sting site.
  • Severe reactions can involve difficulty breathing, swelling of the throat, and dizziness.
  • Anaphylaxis is a life-threatening reaction that requires immediate medical attention.

Spider bites are rarely dangerous, and most can be managed with basic first aid

Diagnosis and When to Seek Help

Most insect bites and stings can be managed at home, but parents should seek medical help if their child experiences:

  • Severe allergic reactions: Difficulty breathing, swelling of the face or throat, dizziness, or fainting (call emergency services immediately).
  • Spreading redness or swelling: This could indicate an infection or an allergic reaction.
  • Persistent symptoms: If pain, itching, or swelling lasts more than a few days.
  • Multiple stings or bites: Especially from venomous insects like wasps or fire ants.

Management

Mild reactions:

  • Wash the area with soap and water.
  • Apply a cold pack to reduce swelling and itching.
  • Use antihistamines or hydrocortisone cream to ease irritation.

Severe reactions:

  • Use an adrenaline (epinephrine) auto-injector immediately if anaphylaxis is suspected.
  • Call emergency services and keep the child lying down with their legs elevated unless they have trouble breathing.
  • Monitor for delayed reactions, as some symptoms may return hours after the initial reaction.

Follow-Up and Monitoring

  • Watch for signs of infection, such as increased redness, warmth, or pus at the bite site.
  • Ensure that your child avoids known insect triggers, especially if they have had an allergic reaction in the past.
  • If your child has a severe allergy, consult a doctor about carrying an adrenaline auto-injector.

With proper care and awareness, most insect bites and stings can be managed safely at home.

History and Exam

Key diagnostic factors

  • Presence of risk factors
  • Witnessed bite/sting
  • Local oedema
  • Local pain

Other diagnostic factors

  • Pustules
  • Bullseye-shaped rash
  • Rash on palms and soles
  • Linear raised rash

Risk factors

  • Occupational or recreational exposure to insects
  • Geographical exposure to insects
  • Previous history of anaphylactic response

Diagnostic Investigations

1st investigations to order

  • Clinical diagnosis

Investigations to consider

  • Serum tryptase
  • Sensitivity testin
  • FBC

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    Other Related Conditions

    food allergy

    eczema

    allergic rhinitis (hayfever)

    ASTHMA

    anaphylaxis

    urticaria (hives)

    drug allergy

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      1 Reason for referral *

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      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 Address