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insect bites and stings

Alternative Names 
black widow spider bite, brown recluse spider bite, bedbug bite, flea bite, wasp sting, yellow jacket sting, bee sting, insect bite, scorpion sting, spider bite, louse bite, tick bite

Definition
An insect bite refers to a puncture wound in the skin caused by an insect when it stings or bites a human.

What are the signs and symptoms of the injury? 
Signs and symptoms can include:
  • a wound from the bite or sting
  • itching
  • swelling
  • redness
  • pain
  • rash
  • wheezing or difficulty breathing
  • visible stinger or an attached insect
What are the causes and risks of the injury? 
Insects are found everywhere, even in cities. The areas of highest risk are usually wooded areas, areas that are not kept clean, and areas where there is a large amount of shrubbery. Insects that are responsible for numerous visits to hospital emergency rooms in Australia each year include:
  • red back spiders
  • funnel web spiders
  • white tail spiders 
  • scorpions
  • hornets
  • honey bees
  • ants
  • Mosquitoes 
  • ticks
  • wasps
  • yellow jackets
  • lice
  • fleas
What can be done to prevent the injury? 
Insects are the largest population of animals in the world. It is impossible to avoid them completely. A person can gain some protection by using proper clothing, insect sprays, and insect-repellant lotions. Also, an individual should be aware of his or her surroundings to avoid contact with insect nests and other places where they live.

How is the injury recognized? 
Most of the time, diagnosis is clear because the person sees the insect when it bites. However, the red, raised area associated with a sting or a bite can appear much later without the person noticing the insect. These bites are much more difficult to diagnose since the type of insect is unknown. However, the size and location of the bite or sting will give an indication of possible sources of the bite.

What are the treatments for the injury? 
For tick bites:
  • Removing the tick's head from under the skin is more important than removing the whole tick. This can be done easily with tweezers. Also, the tick can be suffocated with Vasoline or mineral oil.
  • After removing the tick's head, the area should be cleaned thoroughly with soap and water. It is important to get rid of bacteria on the skin. Most infections following a tick bite are the result of the unclean skin rather than the tick itself.
  • If the head of the tick cannot be removed, a person should see a healthcare provider for removal, and for information about Lyme disease.
For other types of stings and bites:
  • Insects bites or stings can cause anaphylaxis in some people. This a potentially life-threatening condition that causes breathing difficulties and possible cardiac arrest. If a person appears to be having trouble breathing, call for medical help immediately. In the meantime, keep the person's airway open, and do not let the individual lie down. If the individual carries injectable medication for treatment of anaphylaxis, it should be given immediately.
During the process, keep the person calm.

If the person is not breathing, cardiopulmonary resuscitation (CPR) should be started immediately.

If the sting appears to have been made by a honeybee, try to remove the sting sac. This scraped out of the wound with a fingernail or other object such as a knife blade. Care should be taken not to pinch the sting sac with fingers or tweezers. This will cause more venom to be released.

Bites by red backs or white tail spiders require immediate medical attention since the venom kills the skin tissue around the bite.

Other steps that should be take after a bite or sting include:
  • washing the wound with soap and lukewarm water and covering it with a clean, cold compress.
  • removing rings and other constricting items.
  • keeping the person still.
  • watching for an allergic reaction such as swelling of the body or difficulty breathing. CPR and first aid should be used if necessary.
  • remaining with the person until medical help arrives.
Also, it is important that the person have an up-to-date tetanus shot. This vaccination is given routinely at childhood vaccinations, and boosted at age 50.

What are the side effects of the treatments? 
Medications used to treat insect bites or stings may cause drowsiness and other minor side effects.

What happens after treatment for the injury? 
The site of the insect bite may itch from several days. It is important for the person to refrain from scratching. This could cause bacteria to enter the wound.

Author: James Broomfield, MD
Reviewer: Dr John Hearne, eknowhow Medical Review Panel
Last Updated: 14/01/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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