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The insect bite

  1. Gastroepato
  2. Dermatology
  3. The insect bite
  4. Allergy
  5. Allergy, 2

 

Tick ​​puncture

 

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Who writes, working in a border hospital, has treated several cases of insect bites, sometimes very serious.

I remember a lady who was pointed in the cleavage by a wasp; from this puncture arose an ugly inflammatory reaction with showy necrosis of the tissues which resulted in a fibrous retraction of the skin of the anterior region of the neck (see picture).

The patient had to contact the experimental surgeon to treat the lesion that had forced her to live with her head bent on the trunk!

Every year, especially in the summer months, about 3-3 million Americans and 1 million Europeans are stung by insects, the bite of hymenoptera, mosquitoes, lice, ticks and fleas. The problem is that these bites can cause serious systemic reactions potentially harmful and lethal to allergic subjects.

Hymenoptera bites

Bees, wasps, yellow wasps, hornets and ants represent the avant-garde of the insect army. In general, venom causes local reactions: pain, redness, edema and itching. Often the bees leave a sting at the site of the sting, which causes pain because it is connected to the venom gland. In fact in case of puncture, with the blade of a clean or flambe' knife (passed to the flame) it is necessary to remove the poison and eliminate the poison bag.

If, on the other hand, you push on the sting, you inject the poison! Then proceed by washing thoroughly with soap and disinfectant water, to remove the debris and bacteria that are inevitably found on the sting.

Let's not forget that the bees also go on the excrement! If the puncture has extended beyond 5 cm, with evident edema it is also necessary to administer cortisone, usually the prednisone by mouth is sufficient to avoid dangerous reactions.

 If, again, the reaction becomes systemic with redness, abdominal pain, itching, nausea and vomiting, anaphylactic shock, chest pain, asthma, asthenia, the problem becomes more serious and it is advisable to request help and go to the hospital. Anaphylactic shock can arise gradually or, sometimes, abruptly and also have a fatal outcome.

For this reason, the intervention is always necessary, even if to prevent the dangerous reactions that follow and it is often necessary to use adrenaline diluted 1: 1000 in the subcutaneous between o, 3 and 0.5 ml. Therefore, an intravenous route must be prepared and the airways must be maintained and the vital signs monitored.

Bronchospasm can be relieved with intravenous and cortisone theophylline. In the following days, after two weeks, malaise with hives, polyarthritis, lymphadenopathy may also appear.

Mosquitos

The bites of the mosquitoes cause blisters with itching, hives, edema, necrosis of the lesions and even anaphylactoid purpura of Henoch-Schonlein. Allergic reactions to substances contained in the mosquito's saliva are particularly allergenic and the lesion can be super infected. So even in this case you need to clean with soap and water and relieve itching with antihistamines for os and cold compresses.

These are the crisops, various types of simulium, gadfly that cause conspicuous local and systemic pain reactions, with local erythema and itching with edema. Here too, soap and water, cortisone-based ointments and observation for dangerous systemic reactions.

Treatment

Minor reactions can be treated as follows:

In case of bee sting, remove the sting to prevent further spread of the poison;
Wash the affected area with soap and water;
Apply a cold compress with ice (for example ice inside a sachet) over the area to reduce swelling and pain;
Apply antibiotic and cortisone creams and take antihistamines by os.
Contact the emergency room where antibiotic therapy and cortisone system can be performed, check the vital and bio-temporal parameters and possible treatment with diluted adrenaline in the most serious cases and assisted ventilation in the event of bronchospasm.

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