Causes
- Bees, wasps, hornets and ants: venom is usually mild and causes only local reaction but may cause anaphylactic shock in previously sensitized persons
- Spiders and scorpions: Most are non-venomous or only mildly venomous
- Other stinging insects
Clinical features
- Swelling, discolouration, burning sensation, pain at the site of the sting
- There may be signs of anaphylactic shock
Differential diagnosis
- Allergic reaction
MANAGEMENT
- If the sting remains implanted in the skin, carefully remove with a needle or knife blade
- Apply cold water/ice
If severe local reaction
- Give chlorpheniramine 4 mg every 6 hours (max: 24 mg daily) until swelling subsides
Child 1-2 years: 1 mg every 12 hours
Child 2-5 years: 1 mg every 6 hours (max: 6 mg daily)
Child 6-12 years: 2 mg every 6 hours (max: 12 mg daily) - Apply calamine lotion prn every 6 hours
If very painful scorpion sting
- Infiltrate 2 ml of lignocaine 2% around the area of the bite
If signs of systemic envenomation
- Consult
Prevention
- Clear overgrown vegetation/bushes around the home
- Prevent children from playing in the bush
- Cover exposed skin while moving in the bush
- Use pest control methods to clear insect colonies