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Arthropod Bites and Stings

James E. Powers, FAAEM, FACEP, DO Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Arthropods are the largest division of the animal kingdom. Two classes, insects and arachnids, have the greatest impact on human health. Arthropods affect humans by inoculating venom...

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

Most treatments are based on consensus recommendations, clinical experience, or retrospective studies. 
ALERT
  • Anaphylaxis is potentially life-threatening. Most deaths occur within 30 to 60 min...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Venom immunotherapy is the cornerstone of treatment for Hymenoptera; 80–98% effective so patients with anaphylaxis should be referred to allergist for testing. 

Patient Monitoring

REFERENCES

1
Herness J, Snyder MJ, Newman RS. Arthropod Bites and Stings. Am Fam Physician. 2022;106(2):137-147. PMID: 35977137
2
Cardona V, Ansotegui IJ, Ebisawa M, et al. World Allergy Organization Ana...

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.

  • Tick-borne ...

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