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Insect bites and stings

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.

Insect and spider bites cause more deaths from poisoning than bites from snakes.

Alternative Names

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.

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

Certain spider bites, such as the black widow or brown recluse, can be serious and 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.

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:

  • Chest pain
  • Face or mouth swelling
  • Difficulty swallowing
  • Difficulty breathing

First Aid

For 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 EpiPen 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:

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.

  1. Wash the site thoroughly with soap and water.
  2. Place ice (wrapped in a washcloth) on the site of the sting for 10 minutes and then off for 10 minutes. Repeat this process.
  3. If necessary, take an antihistamine, or apply creams that reduce itching.
  4. 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.

When to Contact a Medical Professional

Call 911 of 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, body-wide reactions to a bee sting, your doctor 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

  • 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.
  • If have severe allergies to insect bites or stings, you should have an emergency kit and EpiPen. Make sure your friends and family know how to use it if you have a reaction.

References

Schlossberg D. Arthropods and leeches. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 380.

Fradin MS. Protection from blood-feeding arthropods. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 41.

Otten EJ. Venomous animal injuries. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 62.

Updated: 1/13/2014

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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