Dr. M.J. Bazos, MD Patient Handout

About Your Diagnosis
Biting insects include ants, fleas, ticks, flies, nosee-ums, and mosquitoes. Stinging insects include bees, wasps, and hornets. In general, these are more
of a nuisance than anything else. However, some individuals are more sensitive and may have allergic responses to certain bites or stings. In addition, the bites of some insects transmit diseases. Most bites or stings will resolve without further problems, and treatment is available for the diseases transmitted by some insects.

Living With Your Diagnosis
Most of the above bites cause local pain or itching at the time of the bite. Redness, swelling, and itching around the bite itself often follows. Within 13 days these have completely resolved. Some potential problems related to specific insects include several different tick fevers such as Rocky Mountain spotted fever and Lyme disease spread by tick bites. Mosquito bites can spread encephalitis. Some individuals are allergic to the bites of specific insects. Any bite can become infected. Stings likewise cause local pain and swelling, but most resolve within a few days. Multiple stings can be a problem for anyone. They cause systemic effects such as generalized swelling, weakness, confusion, and difficulty in breathing. Systemic effects also include fainting, vomiting, and diarrhea. Kidney failure, cardiac arrest, and death can occur in severe cases.

For stings, you should carefully remove the stinger. You should be careful not to squeeze the venom sack if still attached to the stinger, because this will inject more venom. For most bites and stings, application of cold will help decrease itching and swelling, as will steroid creams and antihistamines. Oral steroids are used for severe or multiple bites. Most bites resolve completely within 13 days. Except for drowsiness with the antihistamines, there are few side effects of treatment. There are specific antibiotic therapies for the tick fevers. Treatment for the encephalitis carried by mosquitoes is frequently supportive care in the hospital. Sometimes powdered meat tenderizer from the grocery store mixed with water to make a paste, will help with bee or wasp stings when applied after the stinger is removed. For hives or more severe allergic reactions, you should see your doctor promptly. If you have had significant reactions to stings, you should talk to your doctor about an epinephrine self-injector.

The DOs
The single best treatment for insect bites or stings is avoidance. Insect repellents are effective for most of these insects, and should be used anytime you will be going out where the insects are. Long sleeves and long pants and a hat will help protect you in mosquito- and tick-infested areas. Mosquito screens on houses and tents will help keep mosquitoes, nosee- ums, and flies at bay. Avoidance of ants is the best policy. Evidence suggests that sweet, floral, or fruity scents may attract some insects (especially bees). If you are in an area with lots of biting or stinging insects, you may want to avoid these scents. If you are sensitive to stings, you must seek medical care rapidly if stung. You may want to carry an epinephrine self-injector. If you find a tick attached to you, it is important to remove it as soon as possible. Grasp the tick as close to the head as possible without crushing the body. Then remove the tick with a gentle steady pull so as not to jerk the head off, leaving it under the skin where it may cause infection.

The DON’Ts
You should try to avoid unnecessary exposure to biting or stinging insects. With enough bites by any of them, you may have systemic reactions develop. In addition, some may be carriers of infectious diseases.

When to Call Your Doctor
You should call your doctor when there is any sign that any insect bite is becoming infected. You should call when signs of of allergic reactions occur, such as hives, itching at sites other than where bitten, difficulty breathing, and difficulty swallowing or talking. The symptoms of encephalitis include headache, fever, confusion, and drowsiness. The symptoms of the tick fevers depend on the specific fever but include rashes, muscle aches, low-grade fever, headache, and joint pain.

All biting insects and spiders: