Insect and scorpion stings are a rare cause of mortality Mortality All deaths reported in a given population. Measures of Health Status. Hymenoptera insects and Centruroides scorpions can potentially lead to serious symptoms due to envenomation. Pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways, swelling Swelling Inflammation, erythema Erythema Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of disease processes. Chalazion, and warmth are common at the site of a sting. Hymenoptera stings may lead to anaphylaxis Anaphylaxis An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. Type I Hypersensitivity Reaction. Venomous scorpion stings can result in neurologic manifestations such as muscle spasms Spasms An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. Ion Channel Myopathy; abnormal head, neck Neck The part of a human or animal body connecting the head to the rest of the body. Peritonsillar Abscess, and eye movements; excessive salivation; and diaphoresis. The diagnosis of insect and scorpion stings is clinical. Management of insect stings includes cleansing the wound, antihistamines Antihistamines Antihistamines are drugs that target histamine receptors, particularly H1 and H2 receptors. H1 antagonists are competitive and reversible inhibitors of H1 receptors. First-generation antihistamines cross the blood-brain barrier and can cause sedation. Antihistamines and pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways relievers, and treatment for anaphylaxis Anaphylaxis An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. Type I Hypersensitivity Reaction. Scorpion stings may require close monitoring, supportive care, benzodiazepines Benzodiazepines Benzodiazepines work on the gamma-aminobutyric acid type A (GABAA) receptor to produce inhibitory effects on the CNS. Benzodiazepines do not mimic GABA, the main inhibitory neurotransmitter in humans, but instead potentiate GABA activity. Benzodiazepines for muscle spasms Spasms An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. Ion Channel Myopathy, and antivenom.
Last updated: 1 Mar, 2022
Insect stings:
Scorpion stings:
The Hymenoptera order includes the following stinging insects:
Venomous scorpions in the United States include:
European honey bee
Image: “European honey bee extracts nectar” by John Severns. License: Public DomainThe striped bark scorpion, Centruroides vittatus
Image: “16417” by CDC/ Margaret A. Parsons. License: Public DomainA red imported fire ant, Solenopsis invicta
Image: “4635” by CDC/ Margaret Parsons. License: Public DomainLocal signs and symptoms:
Systemic signs and symptoms ( anaphylaxis Anaphylaxis An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. Type I Hypersensitivity Reaction):
Erythema Erythema Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of disease processes. Chalazion surrounding a wasp sting on a patient’s arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy
Image: “21543” by CDC/Dr. Scott. License: Public DomainLocalized erythema Erythema Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of disease processes. Chalazion and swelling Swelling Inflammation at the site of a wasp sting on a patient’s shoulder
Image: “21541” by CDC/Dr. Scott. License: Public DomainSignificant
swelling
Swelling
Inflammation of the dorsal surface of a woman’s right
forearm
Forearm
The forearm is the region of the upper limb between the elbow and the wrist. The term “forearm” is used in anatomy to distinguish this area from the arm, a term that is commonly used to describe the entire upper limb. The forearm consists of 2 long bones (the radius and the ulna), the interosseous membrane, and multiple arteries, nerves, and muscles.
Forearm: Anatomy and
hand
Hand
The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves.
Hand: Anatomy after having been stung by a yellow jacket:
Note the
erythema
Erythema
Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of disease processes.
Chalazion around the site of the sting on the dorsum of the right
hand
Hand
The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves.
Hand: Anatomy.
A number of pustular lesions caused by the bites of fire ants:
Note the erythematous ring, which surrounds the pustular center.
Local signs and symptoms:
Systemic signs and symptoms (envenomation):
Complications:
Insect and scorpion stings are clinical diagnoses.
General management:
Management of severe allergic reactions Allergic Reactions Type I hypersensitivity reaction against plasma proteins in donor blood Transfusion Reactions and anaphylaxis Anaphylaxis An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. Type I Hypersensitivity Reaction:
Prevention:
Most stings only require supportive care. Care for venomous scorpions may include: