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insect bite
Clinical manifestations:
1) normal reaction following any sting or bite
a) immediate local pain with swelling
b) subsides within 1-2 hours
c) pruritus that may persist for days
d) small papule or wheal is common
2) painful wheal followed by vesicles & pustules is typical for fire ant bite lasting up to 72 hours
* images [3,4]
Laboratory:
1) leukocytosis & hyperglycemia typical of stress reaction
2) generally laboratory tests not useful
Differential diagnosis:
1) atopic dermatitis
2) allergic or contact dermatitis
3) viral infection
4) drug eruption
Management:
1) cool compresses
2) topical lotions
a) camphor-menthol
b) pramoxine preparations (Caladryl)
c) calamine
3) secondary infection
- localized impetigo treated with topical mupirocin
- more extensive infection treated as cellulitis with oral or intravenous antibiotics (cefazolin 1st line)
4) antihistamines
a) chlorpheniramine 4-8 mg every 6 hours
b) diphenhydramine 50 mg PO every 6 hours
5) prednisone 40 mg PO for 2-3 days
Related
Chigger
hymenoptera (insect) sting
tick bite
General
animal bite
superficial injury/trauma
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 1172-74
- Medical Knowledge Self Assessment Program (MKSAP) 15, 17
American College of Physicians, Philadelphia 2009, 2015
- Healthline: What Caused This Bug Bite? (images)
http://www.healthline.com/health/bug-bites
- Bad Bugs Slideshow: Identifying Bugs and Their Bites (images)
WebMD
http://www.webmd.com/allergies/ss/slideshow-bad-bugs
- Haddad V Jr, Cardoso JL, Lupi O, Tyring SK.
Tropical dermatology: Venomous arthropods and human skin:
Part I. Insecta.
J Am Acad Dermatol. 2012 Sep;67(3):331.e1-14
PMID: 22890734
- Haddad V Jr, Cardoso JL, Lupi O, Tyring SK.
Tropical dermatology: Venomous arthropods and human skin:
Part II. Diplopoda, Chilopoda, and Arachnida.
J Am Acad Dermatol. 2012 Sep;67(3):347.e1-9;
PMID: 22890735