Insect bites and stings can cause an immediate skin reaction. Symptoms vary depending on the type of insect involved and the sensitivity of the person who is bitten. The bite from fire ants and the sting from bees, wasps and hornets are usually painful but bites caused by mosquitoes, fleas and mites are more likely to cause itching than pain. When an insect bites, it releases a form of saliva that can lead to hypersensitivity reactions known as papular urticaria, which consists of chronic or recurrent eruptions of pruritic papules, vesicles and wheals.1
Some people have a severe allergic reaction to insect bites and stings. This life-threatening allergic reaction is known as anaphylaxis and it requires urgent emergency care. Symptoms of anaphylaxis include feeling faint or passing out, difficulty in breathing, facial swelling, swelling of the tongue, abdominal pain and shock. Anaphylaxis episodes range in severity from those that are mild and resolve spontaneously to those that are fatal within minutes.2
Children affected by insect bites and the associated hypersensitivity reactions are frequently misdiagnosed and often subject to expensive investigations and unnecessary procedures.3 Secondary bacterial infections such as impetigo, cellulitis or lymphangitis are common complications of insect bites.
General steps of first aid for most bites and stings are the following:
In case of emergencies:
1.Demain JG. Papular urticaria and things that bite in the night. Curr Allergy Asthma Rep. 2003; 3: 291–303.
2.Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2008; 121(2 Suppl): S402–S407; quiz S420.
3.Hernandez RG, Cohen BA. Insect bite-induced hypersensitivity and the SCRATCH principles: A new approach to papular urticaria. Pediatrics. 2006 ; 118(1): e189–e196.
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