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Arthropod Bites and Stings

James E. Powers, DO, FACEP, FAAEM Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Arthropods are the largest division of the animal kingdom. Two classes, insects and arachnids, have the greatest impact on human disease.

  • Arthropods affect humans by inoculating poiso...

DIAGNOSIS

HISTORY

  • Sudden onset of pain or itching with visualization of arthropod

  • Many cases unknown to patient or asymptomatic initially (bed bugs, lice, scabies, ticks). Consider in patients presentin...

TREATMENT

ALERT

  • Rapid anaphylaxis is severe and potentially life-threatening. Most deaths due to anaphylaxis occur within 30 to 60 minutes of sting.

  • Give Epinephrine as soon as diagnosis of anaphylaxis ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Immunotherapy as recommended by allergist

  • Venom immunotherapy cornerstone of treatment for Hymenoptera; 80–98% effective (1)

  • Provide epinephrine for patient self-ad...

REFERENCES

1
1 Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis—a practice parameter update 2015. Ann Allergy Asthma Immunol.  2015;115(5):341–384. {L-End} {L-End} [View Abstract on Ovid...

ADDITIONAL READING

CODES

ICD10

  • T63.481A Toxic effect of venom of arthropod, accidental, init

  • T63.301A Toxic effect of unsp spider venom, accidental, init

  • T63.484A Toxic effect of venom of oth arthropod, undetermined, init

  • T...

CLINICAL PEARLS

  • Urgent administration of epinephrine is the key to successful treatment of anaphylaxis.

  • Local treatment and symptom management are sufficient in most insect bites and stings.

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