Insect Bites and Stings and Spider Bites

Emergencies

Yes	Do you have any of the following symptoms that require emergency treatment? Call 911 or other emergency services immediately.

• Signs of shock occur:
  • In children.
  • In adults and older children.
• Moderate to severe difficulty breathing occurs:
  • In children.
  • In adults and older children.
• You have had a previous severe allergic reaction (anaphylaxis) to a similar bite or sting.
• Rapid swelling of the throat or tongue occurs.
• An uncontrolled jerking of muscles (seizure) occurs along with unresponsiveness. Protect the person from harm during the seizure.
• You have swelling of the eyeball (not around the eye or the eyelid).

Note:

Use an allergy kit prescribed by your doctor for a known allergy problem if all of the following are true: Your symptoms are severe. You have a kit immediately available. You have been instructed in how and when to use an allergy kit. You have had a severe reaction to the same or a similar insect or spider and you are beginning to have symptoms of a similar reaction.

Note:

Do not use the kit if you are not currently having any symptoms of an allergic reaction, even if you had a severe reaction in the past.

Check Your Symptoms

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have the following, evaluate those symptoms first.

• Tick bite: Go to the topic Tick Bites.

Yes	Have you used an epinephrine shot to treat an allergic reaction or been accidentally stuck with an epinephrine shot?
Yes	Have you been bitten, stung, or had contact with a poisonous spider, scorpion, or puss caterpillar?
Yes	Have you developed mild difficulty breathing or wheezing following a bite or sting?
Yes	Do you have hives following a bite or sting?
Yes	Do you have pain, burning, or numbness at the site of bite or sting?
Yes	Do you have tiny purple or red spots (petechiae) on your body following a bite or sting?
Yes	Do you have muscle spasms or muscle stiffness after a bite or sting?
Yes	Do you have a blister, painful sore, or purple discoloration at the site of a bite or sting?
Yes	Do you have new swelling?
Yes	Have you had multiple bites or stings, other than from mosquitoes?
Yes	Have 2 or more flu-like symptoms developed within minutes or up to 3 weeks of a bite or sting?
Yes	Do you think you have a skin infection at the site of a bite or sting?
Yes	Do you know or think you need a tetanus shot?

Other Symptoms to Watch For

Do you have any of the following symptoms?

• An expanding red rash that has developed within 3 weeks of an insect bite: Go to the topic Tick Bites.
• Symptoms of scabies: Go to the topic Scabies.
• Symptoms of lice: Go to the topic Lice.
• Symptoms that concern you after having traveled to a malaria-infected country in the past 12 months: Go to the topic Malaria.
• A blister or bump on the skin that you are not sure was caused by an insect or spider: Go to the topic Blisters or Skin Changes.
• A rash, but you are unsure if you were bitten or stung: Go to the topic Rash, Age 12 and Older or Rash, Age 11 and Younger.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

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Author:	Jan Nissl, RN, BS	Last Updated: February 1, 2008
Medical Review:	William M. Green, MD - Emergency Medicine Sean P. Bush, MD, FACEP - Emergency Medicine and Envenomation Specialist
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