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Insect bites and stings
     
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Insect bites and stings

Bee sting; Bed bug bite; 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 

 

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

Insect and spider bites cause more deaths from venom reactions than bites from snakes.

Considerations

 

In most cases, bites and stings can be easily treated at home.

Some people have extreme reactions that require immediate treatment to prevent death.

Certain spider bites, such as the black widow or brown recluse, can cause serious illness or death. Most spider bites are harmless. If possible, bring the insect or spider that bit you with you when you go for treatment so it can be identified.

 

Symptoms

 

Symptoms depend on the type of bite or sting. They may include:

  • Pain
  • Redness
  • Swelling
  • Itching
  • Burning
  • Numbness
  • Tingling

Some people have severe, life-threatening reactions to bee stings or insect bites. This is called anaphylactic shock. This condition can occur very quickly and lead to rapid death if not treated quickly.

Symptoms of anaphylaxis can occur quickly and affect the whole body. They include:

  • Abdominal pain or vomiting
  • Chest pain
  • Difficulty swallowing
  • Difficulty breathing
  • Face or mouth swelling
  • Fainting or lightheadedness
  • Rash or skin flushing

 

First Aid

 

For severe reactions, first check the person's airways and breathing. If necessary, call 911 and begin rescue breathing and CPR. Then, follow these steps:

  1. Reassure the person. Try to keep them calm.
  2. Remove nearby rings and constricting items because the affected area may swell.
  3. Use the person's EpiPen or other emergency kit, if they have one. (Some people who have serious insect reactions carry it with them.)
  4. If appropriate, treat the person for signs of shock. Remain with the person until medical help arrives.

General steps for most bites and stings:

Remove the stinger 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.

Wash the site thoroughly with soap and water. Then, follow these steps:

  1. Place ice (wrapped in a washcloth) on the site of the sting for 10 minutes and then off for 10 minutes. Repeat this process.
  2. If necessary, take an antihistamine or apply creams that reduce itching.
  3. Over the next several days, watch for signs of infection (such as increasing redness, swelling, or pain).

 

Do Not

 

Use the following precautions:

  • DO NOT apply a tourniquet.
  • DO NOT give the person stimulants, aspirin, or other pain medicine unless prescribed by a health care provider.

 

When to Contact a Medical Professional

 

Call 911 or your local emergency number if someone with a sting has the following symptoms:

  • Trouble breathing, wheezing, shortness of breath
  • Swelling anywhere on the face or in the mouth
  • Throat tightness or difficulty swallowing
  • Feeling weak
  • Turning blue

If you had a severe, bodywide reaction to a bee sting, your provider should send you to an allergist for skin testing and therapy. You should receive an emergency kit to carry with you wherever you go.

 

Prevention

 

You can help prevent insect bites and stings by doing the following:

  • Avoid perfumes and floral-patterned or dark clothing when walking through woods, fields or other areas which are known to have large number of bees or other insects.
  • Avoid rapid, jerky movements around insect hives or nests.
  • Do not put hands in nests or under rotted wood where insects may gather.
  • Use caution when eating outdoors, especially with sweetened beverages or in areas around garbage cans, which often attract bees.

 

 

References

Boyer LV, Binford GJ, Degan JA. Spider bites. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 43.

Otten EJ. Venomous animal injuries. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 55.

Seifert SA, Dart R, White J. Envenomation, bites, and stings. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 104.

Suchard JR. Scorpion envenomation. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 44.

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  • Bedbug - close-up

    Bedbug - close-up

    illustration

  • Body louse

    Body louse

    illustration

  • Flea

    Flea

    illustration

  • Fly

    Fly

    illustration

  • Kissing bug

    Kissing bug

    illustration

  • Dust mite

    Dust mite

    illustration

  • Mosquito, adult feeding on the skin

    Mosquito, adult feeding on the skin

    illustration

  • Wasp

    Wasp

    illustration

  • Insect stings and allergy

    Insect stings and allergy

    illustration

  • Brown recluse spider

    Brown recluse spider

    illustration

  • Black widow spider

    Black widow spider

    illustration

  • Stinger removal

    Stinger removal

    illustration

  • Flea bite - close-up

    Flea bite - close-up

    illustration

  • Insect bite reaction - close-up

    Insect bite reaction - close-up

    illustration

  • Insect bites on the legs

    Insect bites on the legs

    illustration

  • Head louse, male

    Head louse, male

    illustration

  • Head louse - female

    Head louse - female

    illustration

  • Head louse infestation - scalp

    Head louse infestation - scalp

    illustration

  • Lice, body with stool (Pediculus humanus)

    Lice, body with stool (Pediculus humanus)

    illustration

  • Body louse, female and larvae

    Body louse, female and larvae

    illustration

  • Crab louse, female

    Crab louse, female

    illustration

  • Pubic louse-male

    Pubic louse-male

    illustration

  • Head louse and pubic louse

    Head louse and pubic louse

    illustration

  • Brown recluse spider bite on the hand

    Brown recluse spider bite on the hand

    illustration

  • Insect bites and stings

    Insect bites and stings

    illustration

    • Bedbug - close-up

      Bedbug - close-up

      illustration

    • Body louse

      Body louse

      illustration

    • Flea

      Flea

      illustration

    • Fly

      Fly

      illustration

    • Kissing bug

      Kissing bug

      illustration

    • Dust mite

      Dust mite

      illustration

    • Mosquito, adult feeding on the skin

      Mosquito, adult feeding on the skin

      illustration

    • Wasp

      Wasp

      illustration

    • Insect stings and allergy

      Insect stings and allergy

      illustration

    • Brown recluse spider

      Brown recluse spider

      illustration

    • Black widow spider

      Black widow spider

      illustration

    • Stinger removal

      Stinger removal

      illustration

    • Flea bite - close-up

      Flea bite - close-up

      illustration

    • Insect bite reaction - close-up

      Insect bite reaction - close-up

      illustration

    • Insect bites on the legs

      Insect bites on the legs

      illustration

    • Head louse, male

      Head louse, male

      illustration

    • Head louse - female

      Head louse - female

      illustration

    • Head louse infestation - scalp

      Head louse infestation - scalp

      illustration

    • Lice, body with stool (Pediculus humanus)

      Lice, body with stool (Pediculus humanus)

      illustration

    • Body louse, female and larvae

      Body louse, female and larvae

      illustration

    • Crab louse, female

      Crab louse, female

      illustration

    • Pubic louse-male

      Pubic louse-male

      illustration

    • Head louse and pubic louse

      Head louse and pubic louse

      illustration

    • Brown recluse spider bite on the hand

      Brown recluse spider bite on the hand

      illustration

    • Insect bites and stings

      Insect bites and stings

      illustration

    A Closer Look

     

    Self Care

     
       

      Review Date: 9/23/2019

      Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 08/06/2020.

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