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Arthropod Bites and Stings

James E. Powers, DO, FACEP, FAAEM Reviewed 06/2019
 


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 poison...

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 studies are retrospective or based on clinical observations. 
ALERT
  • Rapid anaphylaxis is severe and potentially life-threatening. Most deaths due to anaphylaxis occur within 30 to 60 minu...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Venom immunotherapy is the cornerstone of treatment for Hymenoptera; 80–98% effective (3)[A]

  • Provide epinephrine for patient self-administration if history of anap...

REFERENCES

1
Alpern JD, Dunlop SJ, Dolan BJ, et al. Personal protection measures against mosquitoes, ticks, and other arthropods. Med Clin North Am.  2016;100(2):303–316. [View Abstract on OvidMed...

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.

  • Tick-borne ...

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