Insect bites

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Etiology – bites (stings) of scorpions, spiders (karakurt), wasps, bees, centipedes.

Clinical picture

    • Scorpion stings
    • Sharp excruciating pain in the area of ​​poison inoculation
    • The severity of hyperemia and edema in the affected area varies. With a weak local reaction, general intoxication is more pronounced than with a significant local inflammatory reaction.
    • Sometimes in the sting zone, along with edema, superficial blisters with serous contents appear.
    • Symptoms of general intoxication are not always noted (more often in preschool children): malaise, headache, dizziness, chills, pain in the heart area, shortness of breath, palpitations, anxiety, alternating with drowsiness and weakness, tremor, small convulsive twitching of the limbs, profuse sweating, saliva – and lacrimation, copious secretion of mucus from the nose, a short-term increase in body temperature up to 38 ° C. Signs of intoxication persist for no more than 24-36 hours, most pronounced in the first 2-3 hours after the bite
    • Not often there is difficulty in breathing with bronchospasm, cyanosis; in the early stages, marked tachycardia and an increase in blood pressure are observed, followed by bradycardia and arterial hypotension.
    • Bites of karakurt
    • Development within 5-20 minutes of pronounced muscle weakness, gait disturbances, ataxia, muscle tremor
    • Excruciating pain in the limbs, lower back and abdomen
    • Severe pain in the abdominal muscles
    • Hyperemia of the face and sclera, swelling of the eyelids, chills, sweating, an increase in body temperature up to 38-39 ° C and blood pressure up to 160/100-220/120 mm Hg.
    • Often fuss-

kaet delayed stool and urination (spasm of sphincters)

    • Perhaps the appearance of meningeal symptoms, pathological reflexes
    • Patients are often agitated, cry out in pain, toss and turn in bed.
    • In the most severe cases, excitation is replaced by a soporous or coma.
    • Wasp and bee stings
    • A sharp local pain reaction with hyperemia and edema in the affected area. Severe intoxication (convulsions, collapse, vomiting, coma) is observed with multiple bites. Severe local and general reactions to single or few bites are due to an allergy to bee or wasp venom.
    • An allergic reaction to wasp and bee stings is a pronounced local edematous reaction with anaphylactic shock, Quincke’s edema, urticaria or bronchospastic syndrome.

Treatment:

    • When scorpion stings
    • Heat and fat ointment dressings at the bite site
    • Injection of the bite site with 1% solution of novocaine
    • Atropine (0.5-1 ml 0.1% solution s.c.)
    • a-Adrenergic blockers, for example, dihydroergotoxin (0.5-1 ml of 0.03% solution s / c)
    • Specific anti-venom sera are needed for tropical scorpion stings.
    • When bitten by a karakurt
    • Repeated administration of 25% magnesium sulfate IV and 10% calcium chloride IV
    • Warming the limbs and body with heating pads, drinking plenty of water
    • With stool retention and intestinal paresis – enemas
    • Urinary retention – bladder catheterization
    • In the most severe cases, a specific anti-karakurt serum is administered.
    • For wasp and bee stings
    • With the traditional reaction to a bite: removal of the sting, cold lotions on the bites (for 10 minutes, alternating with ten-minute breaks)
    • With local or general signs of a hyperergic reaction to a bite, immediate intensive antiallergic therapy: adrenaline s / c, norepinephrine or mezaton in / in drip, hydrocortisone or prednisolone in / in, antihistamine products; strophanthin. Due to the danger of a lightning-fast reaction, the victim needs constant medical supervision in the first hours after the lesion.

Forecast for scorpion stings: lethal cases in Russia are unknown, stings of tropical scorpions living in North Africa and South America are much more dangerous. With a bite of a karakurt, the prognosis is favorable, fatal outcomes are rare. With the development of an allergic reaction to wasp and bee stings, death can occur within the first 20 minutes. See also Shock, Angioedema ICD

  • T63.2 Toxic effect of scorpion venom
  • T63.3 Toxic effect of spider venom
  • T63.4 Toxic effect of other arthropod venom