insect bite

Clinical manifestations

• normal reaction following any sting or bite
  • immediate local pain with swelling
  • subsides within 1-2 hours
  • pruritus that may persist for days
  • small papule or wheal is common
• painful wheal followed by vesicles & pustules is typical for fire ant bite lasting up to 72 hours

* images

Laboratory

• leukocytosis & hyperglycemia typical of stress reaction
• generally laboratory tests not useful

Differential diagnosis

• atopic dermatitis
• allergic or contact dermatitis
• viral infection
• drug eruption

Management

• cool compresses
• topical lotions
  • camphor-menthol
  • pramoxine preparations (Caladryl)
  • calamine
• secondary infection
  • localized impetigo treated with topical mupirocin
  • more extensive infection treated as cellulitis with oral or intravenous antibiotics (cefazolin 1st line)
• antihistamines
  • chlorpheniramine 4-8 mg every 6 hours
  • diphenhydramine 50 mg PO every 6 hours
• prednisone 40 mg PO for 2-3 days

More general terms

• animal bite
• superficial injury/trauma

Additional terms

• Chigger
• hymenoptera (insect) sting
• tick bite