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Bites and Stings

Insect Stings


Presentation

  • Latrodectism is related to neurotoxins present in the venom of widow spiders. Most cases present with headache, lethargy, irritability, myalgia, tremor, fasciculation, or ataxia.[ncbi.nlm.nih.gov]
Animal Bite
  • Emergency Physicians frequently see patients who complain of an allergic reaction to an animal bite or sting.[ncbi.nlm.nih.gov]
Localized Pain
  • A local reaction consists of sharp, localized pain followed by a reddening at the site, which usually resolves itself in 24 hours.[ncbi.nlm.nih.gov]
  • Though a sting can cause severe local pain, the venom is not lethal and no deaths have been recorded.[sielearning.tafensw.edu.au]
  • Most cause only transient local pain and/or itching, but about 1 percent of Americans experience severe allergic reactions to insect venom; about fifty die each year. Furthermore, these pests can transmit diseases.[motherearthliving.com]
  • If bee, European wasp, ant or non-tropical minor jellyfish sting is suspected apply an ice pack for 15 minutes at a time to reduce local pain and swelling.[conditions.health.qld.gov.au]
  • “Most ant bites cause localized pain and swelling, but typically do not have significant whole-body effects,” says Dr. Patrick Mahaney of Los Angeles, California.[petmd.com]
Sepsis
  • Infectious complications were seen in 127 patients, among them 94 soft tissue infections (74.1%), 28 cases of sepsis (22.0%) and five of endocarditis (3.9%).[ncbi.nlm.nih.gov]
  • The lesion sometimes becomes infected and can lead to sepsis. In some cases, an edematous, erythematous, and pruritic lesion, rather than a pustule, develops. Anaphylaxis due to fire ant stings probably occurs in 1% of patients.[merckmanuals.com]
  • Arsenicum (2): Indicated when a bite has become infected by dead tissue or animal substances have remained in the wound causing sepsis. The lesion takes on a dark, black, unhealthy look and moves toward gangrene.[simillimum.com]
Marine Animal Bite Or Sting
  • Marine animal bites and stings In the waters around Australia there are many types of fish, jellyfish and other marine animals that can inflict painful and sometimes life threatening bites and stings.[sielearning.tafensw.edu.au]
Soft Tissue Swelling
  • We present sonographic findings of 4 cases of soft tissue swelling from insect bites and stings suggestive of angioedema.[ncbi.nlm.nih.gov]
Numbness of the Tongue
  • Signs and symptoms of a blue-ringed octopus bite Can include: small painless scratch or bite weakness in the legs numbness of the tongue and face paralysis collapse breathing may stop.[sielearning.tafensw.edu.au]
Hypotension
  • Allergic reactions may manifest with urticaria, angioedema, bronchospasm, refractory hypotension, or a combination; swelling alone is not a manifestation of allergic reaction.[merckmanuals.com]
  • Severe systemic reaction A severe systemic response to ant venom is marked by clinical manifestations in 2 organ systems distant from the bite/sting, such as angioedema (especially of larynx ), flushing, hoarseness, wheezing/bronchospasm, chest pain, hypotension[dermnetnz.org]
  • Pain, burning, edema and anaphylaxis can accompany the local skin reaction. 17 Systemic reaction can include generalized urticaria, angioedema, bronchospasm, laryngeal edema and hypotension. 17 Anaphylaxis can occur similar to stings from other insects[podiatrytoday.com]
Hypertension
  • The clinical picture of scorpion sting envenoming is dominated by muscle weakness associated with arterial hypertension, cardiac arrythmias, myocarditis, or pulmonary edema.[ncbi.nlm.nih.gov]
Muscle Weakness
  • The clinical picture of scorpion sting envenoming is dominated by muscle weakness associated with arterial hypertension, cardiac arrythmias, myocarditis, or pulmonary edema.[ncbi.nlm.nih.gov]
  • Progressive reaction from tiredness to muscle weakness and unsteadiness on feet, double vision and difficulty breathing or swallowing to (rarely) paralysis.[mydr.com.au]
  • The main symptom of tick paralysis is muscle weakness, poor coordination, or paralysis spreading upwards (towards the head) from the site of a tick bite or an attached tick.[medbroadcast.com]
  • Symptoms and signs – Not all may be present pain swelling of the bite or sting area discolouration of the affected area altered sensation – e.g. numbness or ‘pins and needles’ nausea or vomiting headache blurred or double vision muscle weakness or paralysis[stjohn.org.nz]
Muscle Twitch
  • Rare symptoms include breathing difficulties, muscle twitching, drooling, sweating, nausea, vomiting, increased heartrate, restlessness, excitability, and inconsolable crying. Severe symptoms are more likely in infants and children than adults.[healthline.com]
Myalgia
  • Most cases present with headache, lethargy, irritability, myalgia, tremor, fasciculation, or ataxia. Loxoscelism is caused by envenoming by spiders of the family Sicariidae. It may present with a stroke due to a severe coagulopathy.[ncbi.nlm.nih.gov]
  • Symptomatic individuals typically present with fever, headache, weakness, myalgia, arthralgia, nausea, vomiting and a transient maculopapular rash.[podiatrytoday.com]
Low Back Pain
  • After an average of 30 minutes the person may develop irukandji syndrome – including severe low back pain, vomiting, muscle cramps, restlessness and anxiety. Dangerously high blood pressure may develop.[mydr.com.au]
Angioedema
  • Soft tissue infections and angioedema from insect bites and stings may be difficult to differentiate by inspection. We present sonographic findings of 4 cases of soft tissue swelling from insect bites and stings suggestive of angioedema.[ncbi.nlm.nih.gov]
  • Skin manifestations include itch, angioedema , urticaria , and redness in areas distant from the bite/sting in more generalised distribution . Gastrointestinal system symptoms may consist of mild nausea, diarrhoea, and/or cramping.[dermnetnz.org]
  • Allergic reactions may manifest with urticaria, angioedema, bronchospasm, refractory hypotension, or a combination; swelling alone is not a manifestation of allergic reaction.[merckmanuals.com]
  • Pain, burning, edema and anaphylaxis can accompany the local skin reaction. 17 Systemic reaction can include generalized urticaria, angioedema, bronchospasm, laryngeal edema and hypotension. 17 Anaphylaxis can occur similar to stings from other insects[podiatrytoday.com]
Convulsions
  • A toxic reaction may include gastrointestinal symptoms, fever, headache, dizziness or convulsions, often following an episode of multiple stings.[ncbi.nlm.nih.gov]
  • Other symptoms include nausea, vomiting, drooling, convulsions, and difficulty breathing. Scorpion bites are treated with antivenins and other medications to control muscle spasms and convulsions.[humanillnesses.com]
  • The venom causes acute pain and can lead to frothing at the mouth, breathing difficulties, and muscle convulsions. Limbs may become immobilized. Though the venom is rarely fatal, its effects can last for as long as seventy-two excruciating hours.[list25.com]
  • During this time, a feeble pulse, cold clammy skin, unconsciousness, convulsions and even death may result if the victim does not receive medical attention immediately. Additional complications may occur due to the infection of the bite.[tpwd.texas.gov]
Rabies
  • For more information and reporting possible cases of rabies, please visit our rabies page.[webcms.pima.gov]
  • Any time there is a bite by an animal there is a danger of rabies and tetanus. It is very important to capture the animal that has bitten so it can be put under observation for rabies.[simillimum.com]
  • No cases of rabies were observed in these patients. CONCLUSION: Animal bite is a major public health problem in Khuzestan, with a high frequency, a high percentage of hospitalization and considerable mortality.[ncbi.nlm.nih.gov]
  • This is a small price to pay considering the symptoms of rabies — general malaise progressing to confusion, agitation, abnormal behavior, hallucinations and, within a few days, death. Once symptoms occur, rabies is not generally survivable.[alertdiver.com]
  • If the attack was unprovoked, consider the possibility of rabies. Notify authorities as soon as possible. Seek medical attention if needed.[tpwd.texas.gov]
Tremor
  • Most cases present with headache, lethargy, irritability, myalgia, tremor, fasciculation, or ataxia. Loxoscelism is caused by envenoming by spiders of the family Sicariidae. It may present with a stroke due to a severe coagulopathy.[ncbi.nlm.nih.gov]
  • Other symptoms include nausea, profuse perspiration, tremors, labored breathing and speech, and vomiting.[tpwd.texas.gov]
  • Tremor, sweating, weakness, chills, nausea, vomiting, headache are other symptoms. The bite area is red with a white center. Read full article on black widow spider bites.[healthline.com]
  • […] simple analgesic such as paracetamol pain spreading from the bite area swollen or painful glands in the affected limb (armpits for bites on the arm or hand, groin for bites on the foot or leg) sweating all over the body, or only in patches shivering tremors[austin.org.au]
Neglect
  • Snake and spider bites, as well as scorpion sting envenoming, are neglected diseases affecting millions of people all over the world.[ncbi.nlm.nih.gov]
  • Infected bites can be fatal if neglected. Surgery and hospitalization may be needed for severe bites. Arthropods SPIDERS Even without treatment, most children recover from black widow bites after two to three days.[healthofchildren.com]
  • Infected bites can be fatal if neglected. Surgery and hospitalization may be needed for severe bites. Arthropods SPIDERS. Even without treatment, adults usually recover from black widow bites after 2-3 days.[medical-dictionary.thefreedictionary.com]
Stroke
  • Snake bite envenoming may result in stroke or muscle paralysis. Metalloproteinases and other substances (common in vipers and colubrids) have anticoagulant or procoagulant activity, and may induce ischemic or hemorrhagic strokes.[ncbi.nlm.nih.gov]
  • You may also get flea bites on your forearms if you've been stroking or holding your pet.[nhs.uk]
  • And then you pull out your mobile phone, you sit down in front of the TV, and together, while stroking her hair softly, you sit and watch Ben and Holly’s Little Kingdom . And then you observe.[kidspot.com.au]
Kidney Failure
  • Rare complications include fever, body aches, nausea, vomiting, hemolytic anemia, rhabdomyolysis, kidney failure. Read full article on brown recluse spider bites.[healthline.com]
  • Stings from large hornets or multiple (hundreds or thousands) bee stings have been reported to cause muscle breakdown and kidney failure and death.[emedicinehealth.com]

Treatment

  • Treatment with extracts of the whole offending insect generally provides good results but the protection afforded by such treatment varies in degree and duration.[ncbi.nlm.nih.gov]
  • Prompt treatment can minimize symptoms and promote recovery.[healthline.com]

Prognosis

  • Prognosis Mammals Prompt treatment and recognizing that even apparently minor bites can have serious consequences are the keys to a good outcome after a mammal bite. Infected bites can be fatal if neglected.[healthofchildren.com]
  • Insect Bites Prognosis Most people respond well to home or emergency treatment for bug bites or stings.[emedicinehealth.com]

Etiology

  • Scabies Definition and Etiology Scabies is an ectoparasite infestation caused by the female mite Sarcoptes scabiei var. hominis.[clevelandclinicmeded.com]

Epidemiology

  • Data including epidemiological aspects, clinical findings and outcomes of treatment were analyzed using descriptive statistics and the chi(2) test.[ncbi.nlm.nih.gov]
  • Heukelbach J, Feldmeier H: Epidemiological and clinical characteristics of hookworm-related cutaneous larva migrans. Lancet Infect Dis 2008;8(5):302-309. Heukelbach J, Feldmeier H: Scabies. Lancet 2006;367(9524):1767-1774.[clevelandclinicmeded.com]
  • Epidemiology of scorpionism: a global appraisal. Acta Trop. 2010;8(107):71-9. Meredith JT. Bites and Stings. In: Tintinalli JE, Kelen GD, Stapczynski JS, eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide . Seventh Edition.[podiatrytoday.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology and Natural History The mode of transmission varies among genera.[clevelandclinicmeded.com]
  • Pathophysiology: The Biologic Basis for Disease in Adults and Children . Elsevier, St. Louis, 2014, pp. 923-952. Barry M, Kauffman CL, Wilson BB, Rozen E, Rosh AJ. Scabies. Medscape Drugs & Diseases. Available at: . Published October 1, 2014.[podiatrytoday.com]

Prevention

  • Because of the rapid onset of anaphylaxis, life-saving measures include awareness in persons who are hypersensitive, emergency preparedness and preventing bites and stings from occurring.[ncbi.nlm.nih.gov]
  • Prevention Before departure, travelers should have a current tetanus vaccination or documentation of having received a booster vaccination within the previous 5–10 years.[webcms.pima.gov]
  • How to prevent bites and stings To help prevent bites and stings, it’s a good idea to wear protective clothing such as closed shoes, socks, long pants and a long sleeved shirt when walking through the bush.[healthdirect.gov.au]

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