1. Insect bites and stings
Paleerat Jariyakanjana, MD
Faculty of Medicine, Naresuan University
17 Jan 2013

2. Venomous Non-venomous
•Bees •Mosquitoes
•Wasps •Fleas
•Hornets •Ticks
•Yellow jackets •Lice
•Fire ants •Scabies
•Bed bugs
•Caterpillars & moths

4. Venomous Non-venomous
•sting •bites
•bee, wasp •feed on your blood
•defence mechanism •intense itching
•injecting toxic and
painful venom

5. Signs and Symptoms
Venomous Non-venomous
•stinging sensation or •little more than papular
pain rash
•redness and swelling •small raised red spot
•Itch: not concern •blister
•anaphylaxis •open sore that may
•rhabdomyolysis become infected
•carriers or vectors of
diseases

7. Management
 No specific antivenin
 Treatment: local wound care and general
supportive measures
 venom apparatus
 removed by scraping edge of scalpel blade parallel to
skin and lifting apparatus away from skin

8. Management
 Ice bag wrapped in towel: reduce pain and
swelling
 Oral antihistamine
 Anaphylaxis
 adrenaline, H1- & H2- blocker, corticosteroids
 Tetanus toxoid: considered
 Antibiotic: controversial

9. Prevention
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10. Prevention
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11. PAEDERUS

13. Paederus dermatitis
 contact dermatitis characterized by a sudden
onset of erythematobullous lesions on exposed
areas of body
 does not bite or sting
 release paederin
 Characteristically lesions
 linear
 kissing lesion
 Scarring usually does not occur.

14. Paederus dermatitis

15. Treatment
 removing irritant by washing area with soap and
water
 blistered site
 cool wet soaks
 topical steroid
 considered oral antibiotic: prevent bacterial infection
 antihistamine

16. Prevention
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17. Reference
 Tintinalli's Emergency Medicine, 7th ed
 Rosen’s emergency medicine, 7th ed
 http://dermnetnz.org/arthropods/bites.html
 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC32
25135/

18. ANY QUESTIONS?