Doctor's Notes on Insect Bites and Stings
Insects are small animal arthropods that have six legs (hexapod invertebrates) and generally one or two pairs of wings. There are an estimated 10 million different insect species. However, the lay press equates insects with almost any small bug that bites or stings. Consequently, insect bites may be attributed to not only small arthropods but to other small invertebrate animals that can either bite, sting, or cause a chemical reaction (for example, blisters or pain) in human skin. Although some individuals would exclude stinging from biting insects, most medical and/or nonmedical individuals include stinging animals when discussing insect bites.
Examples of insect bites include mosquito bites, fire ant stings, bee stings, wasp stings, flea bites, chigger bites, tick bites, brown recluse spider bites, black widow spider bites, reduviid bug (also termed kissing bugs or Triatomine bugs) bites, puss caterpillar (skin reaction to released chemical skin irritant), and blister beetle (skin reaction to released chemical skin irritant).
If you can safely capture the insect or bug that likely bit or stung you, this may help your doctor to design the best treatment, if any, for you. However, if you develop any problems like tissue swelling or shortness of breath, go immediately to the emergency department.
The following are signs and symptoms of common insect bites:
- Mosquito bites produce reddish raised, itchy lesions.
- Fire ant stings produce blisters that are small and have pus in the center of the blister.
- Bee stings with painful welt with possible mark in the center where the bee stung
- Wasp stings are similar to bee sting.
- Flea bites with small red bumps that itch, mainly on the legs and ankles
- Chigger bites with small red lesions usually in warm areas like the waist, elbow, and knee folds
- Tick bites after or during the initial bite; the initial bite site may be reddish
- Brown recluse spider bites begin as reddish skin that can develop into a skin ulcer.
- Black widow spider bites begin as two red puncture marks and can ulcerate.
- Reduviid bug bites get contaminated with bug's feces; reddish-brown skin rash
- Puss caterpillar (skin reaction to released chemical skin irritant); two to four rows of painful, reddish, small lesions that mimic the shape of the caterpillar
- Blister beetle (skin reaction to released chemical skin irritant when bug is crushed): painful skin blisters, some lesions
Although most insect bite signs and symptoms usually only last a few days, many insects are vectors that may carry viruses, bacteria, and parasites that can harm humans or even kill them. Mosquitos can be vectors of several diseases that include malaria, yellow fever, West Nile, dengue, elephantiasis, and Zika virus. Depending on the type of tick, Lyme disease (signs and symptoms of reddish target lesions) or Rocky Mountain spotted fever (symptoms include small reddish rash) can be transmitted to humans. Reduviid bug bites can transmit the parasites that cause Chagas disease with symptoms and signs that include fever, eyelid swelling, headache, and splenomegaly. Stings from such insects as bees, wasps, and other flying insects that bite can cause allergic reactions that can be life-threatening such as swelling of the tongue or throat that can stop breathing if not treated emergently. Some skin lesions produced by insect bites may become infected. Brown recluse spider bites can result in local tissue destruction and crater-like scarring while the black widow spider bites can cause severe muscle cramping and central nervous system excitation due to the neurotropic toxin released in the bite.
What Are the Treatments for Insect Stings or Bites?
Treatments of insect bites and stings depend on the type of insect. However, there are general initial treatments that may be used for most stings and bites:
- Safely remove the patient from the area to prevent additional stings, bites, or irritating agents.
- Remove the stinger, biting insect, or irritating agents (like hairs from a caterpillar).
- Wash the area with soap and water.
- Apply a cold compress for at least 10 minutes.
- Elevate the bite or sting area above your heart to reduce swelling.
- Consider pain control with acetaminophen or ibuprofen. (Caution: Be aware of limitations of use in children.)
Call 911 if the person is allergic to certain bites and stings and develops more severe problems like difficulty breathing, swelling of face, or oral tissues, rapid heartbeat, can't swallow normally, or loss of consciousness. If an EpiPen is available, consider using it.
Allergies : Symptoms & Home Remedies QuizQuestion
Allergies can best be described as:See Answer
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Allergic ReactionAn allergic reaction is an overreaction to a harmless substance. Symptoms and signs of an allergic reaction include hives, rashes, swelling, itching, wheezing, nausea, and even anaphylactic shock in severe reactions. Treatment involves avoiding triggers, taking oral antihistamines, applying anti-inflammatory steroid creams, and using an EpiPen.
Bedbugs (Bed Bugs)Bedbugs are blood-sucking parasites that feed on mammals and birds. Symptoms and signs of bedbug bites include reddish-colored skin lesions and localized itching. Benadryl may be used to control the itch of bedbug bites.
Bee and Wasp StingsBees and wasps are venomous, meaning they have poison stings that may cause pain, swelling, and allergic reactions. If a person with no allergic symptoms receives a sting, a home remedy may be all that is necessary for relief. A group of many stings or an allergic reaction to a sting may require emergency medical treatment.
Black Widow and Brown Recluse Spider BiteBlack widow spider and brown recluse spider bites in the wilderness present a medical emergency. If bitten by either of these spiders, seek medical attention immediately. Anti-venom is one treatment for a black widow spider bite. There is no anti-venom for a brown recluse spider bite.
Black Widow Spider BiteThe bite of a black widow spider can be serious, but it's rarely fatal. Adults with black widow bites seldom have complications. Symptoms include pain, muscle pain in large muscle groups, nausea, and sometimes vomiting and fainting. Go to the emergency department if the pain is more than minor, and call paramedics if symptoms are severe.
Brown Recluse Spider BitesThe brown recluse spider is notable for its characteristic violin pattern on the back of the body part to which the legs attach. Symptoms of a brown recluse spider bite include: severe pain, severe itching, vomiting, nausea, fever, and muscle pain. A person who has been bitten by a brown recluse spider bite should seek medical treatment.
Chigger BitesChiggers are a type of mite. Chiggers most commonly bite areas of thinned skin and folds. Chiggers do not burrow into the skin, but inserts feeding structures and mouth parts into the skin. Symptoms of chigger bites include: intense itching, a red raised bump, blister, or pimple. Treatment is generally with over-the-counter anti-itch creams.
Chiggers vs. ScabiesBoth chiggers and scabies mites usually cannot be seen with the naked eye. Chiggers do not burrow under the skin. They inject enzymes that destroy tissue. Scabies mites burrow under the skin and feed on the skin. Both chigger and scabies bites cause symptoms like pain, redness, bumps, blisters. Both chiggers and scabies mites are parasites. Chigger and scabies mites bites can be treated at home without medical treatment.
Crabs (Pubic Lice) Symptoms, Transmission, and TreatmentCrabs (pubic lice) is a parasitic infection. Causes of crabs include sexual contact with an infected person, contaminated towels, bedding, or clothing. The main symptom of crabs (pubic lice) are burning and itching of the pubic area. Treatment for crabs is medication that kills the parasite.
Dengue FeverDengue fever is a disease transmitted to humans via mosquito bites. Dengue fever symptoms and signs include rash, fever, headache, and joint pain. Diagnosis may involve a complete blood count and spinal tap to rule out other diseases. Adequate hydration and pain-control medications will help to manage dengue fever symptoms.
Hives and AngioedemaHives are a sudden allergic skin reaction. Hives are raised reddish bumps that cause severe itching. Angioedema is similar to hives but the welts are larger and involve a deeper layer in the skin. Allergies, insect stings and bites, stress, exercise, and infections are common causes of hives and angioedema. In mild cases, no treatment is needed. Severe reactions should be treated by a health care professional.
Land Animal BiteA person attacked by a land animal should attempt to identify the type of animal, the time of the injury, and the nature of the attack. All animal bites should be cared for by a medical professional.
MalariaMalaria is a disease transmitted by the bite of an infected mosquito. Symptoms and signs include high fever, body aches, headache, nausea, weakness, and chills. Treatment may involve administering oral medications, fluids, and possible IV drug therapy.
Plague Disease (Black Death)Plague is a term applied to an infectious disease that spreads easily and, without antibiotics treatment, can be fatal. Plague symptoms and signs include fever, sore throat, abdominal pain, nausea and vomiting, buboes, and blackened tissue. Once the patient is isolated, antibiotics are administered.
SalmonellaSalmonella is a bacterial that can cause infectious diseases in humans. You get Salmonella by ingesting contaminated food or water and the infection is referred to as "food poisoning." Symptoms and signs of Salmonella infection include diarrhea, nausea, vomiting, and possibly fever. Sometimes Salmonella requires no treatment, other times a doctor may prescribe antibiotics.
Severe Allergic Reaction (Anaphylactic Shock)Anaphylactic shock is a severe allergic reaction that is life-threatening. The symptoms of anaphylactic shock are breathing problems, shock, or death. A severe allergic reaction may be caused by an insect sting or certain foods to which the body has been "sensitized" and has developed a powerful antigen for. Anaphylactic shock is an emergency and requires immediate medical treatment.
Snakebite (Snake Bite)There are about 400 of 3,000 snake species worldwide are venomous. Approximately 25 species of venomous snakes are found in North America. Two major families of snakes account for most of the venomous snakes dangerous to humans. The elapid family includes cobras, mambas, coral snakes, tiger snakes, and death adders. The viper family includes rattlesnakes, saw-scaled vipers, Russell's viper, and the puff adder. If a person is bitten by a snake they should go to an emergency department, regardless if they feel the snake is nonvenomous.
Tetanus (Lockjaw)Tetanus is an infectious disease caused by contamination of wounds from the bacteria Clostridium tetani, or the spores they produce that live in the soil, and animal feces. Tetanus symptoms and signs include muscle cramps, lockjaw, weakness, and difficulty swallowing. A tetanus shot/vaccine is used to prevent tetanus. Tetanus treatment includes antibiotics, wound cleansing, pain medicine, sedatives to control muscle spasms, and IV fluids.
TicksThere are more than 800 species of ticks worldwide. Ticks transmit diseases such as Lyme disease, Rocky Mountain spotted fever, Q fever, tularemia, babesiosis, and ehrlichiosis. Tick bite symptoms include fever, rash, weakness, nausea and vomiting. Treatment involves removing the tick with tweezers, cleaning the bite area with soap and water, and applying antibiotics to the bite.
West Nile VirusWest Nile virus is a Flaviviridiae virus transmitted to humans by mosquito bites. West Nile virus infection typically begins with the abrupt onset of symptoms including fever, chills, muscle aches, headache, and flu-like symptoms. There is no known effective antiviral treatment or vaccine to prevent West Nile virus.
Wound CareWounds are lacerations, cuts, or punctures in the skin. Wounds can be superficial, deep, punctures, or pressure sores. The amount of pain, inflammation, and bleeding depend on the type of wound. Most superficial wounds can be treated at home. Deep wounds, or complicated wounds generally need medical care. Sutures, staples, or surgical glue for a wound depend on the depth of the wound and the time lapse between the injury and when medical care is sought.
Yellow FeverSymptoms of yellow fever include jaundice, high fever, backache, headache, nausea and/or vomiting. Learn more about what causes yellow fever and how it can be treated.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.