This document summarizes information about insect bites and stings. It categorizes insects as either venomous or non-venomous, and describes their signs, symptoms, and methods of biting or stinging. For treatment, it recommends local wound care, oral antihistamines, adrenaline, and antibiotics in some cases. Prevention methods include protective clothing and insect repellent. It also provides details about Paederus dermatitis, a skin reaction caused by contact with certain beetles.

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?