Insect Bites & Stings, and Pediculosis Objectives Identify signs and symptoms of insect bites and stings and pediculosis Provide non pharmacologic treatment options for insect bites and stings and pediculosis Recommend appropriate nonprescription therapy for insect bites and stings and pediculosis given patient specific presentation and history Recognize when self case is not appropriate – (when to refer to primary care provider) Insect Bites Nonvenemous Insects Mosquitoes Fleas Bedbugs Nonvenemous Arachnid Ticks Chiggers Scabies
Mosquitoes Found worldwide More abundant in warm, humid climates Most prevalent in early morning and at dusk Land on skin → inject anticoagulant saliva Causes welt, itching (“mosquito bite”) Complications Mosquitoes transmit more diseases to humans than any other biting insect Malaria West Nile Virus Dengue Fever Yellow fever Fleas Tiny bloodsucking insects, found worldwide Breed best in humid climate Bites in humans common when: Moving into vacant flea-infested habitat Living with infested pets Bites usually multiple, grouped Erythematous region, intense itching Legs, ankles in humans Complications Transmission of disease Bubonicplague Endemictyphus Bedbugs Hide during the day, bite victims at night Hide in bedding, crevices of walls, floors, furniture, picture frames, folds of linens, corners of suitcases Bite emits anesthetic and anticoagulant Increased concern of bedbug infestation in the US with growing mobility of society Places frequented by travelers (hotels) Bites Clusters of 2s and 3s, straight line Exposed areas of skin: head, neck, arms Reactions vary – depend on sensitivity of individual Irritation at the site → small dermal hemorrhage Currently no link to spread of diseases Ticks Feed on human and animal blood Mouthparts of tick are introduced into the skin during “feeding” Able to hold firmly Tick should be removed within 36 hours Use fine tweezers, grasp near head and gently pull If mouthparts are left behind when tick is removed → Intense itching, nodules Do not use heating methods, do not paint anything onto tick If not removed Tick fully engorged with blood remains attached up to 10 days before dropping of Local reaction: itching papules → disappear within 1 week Tick Complications (systemic) Lyme Disease Caused by bacteria found in Deer ticks Transmitted after tick attached for 36 hours Acute: flu-like symptoms, rash Rash: papule → enlarged circle with clear center (“bull’s- eye”) Tender lesions 3-22 days after bite Disappear within 3-4 weeks If untreated → neurologic symptoms, cardiac disturbances Rocky Mountain Spotted Fever Transmitted by Wood ticks or Dog ticks Severe headache, rash, high fever, extreme exhaustion Chiggers
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- Fall '08
- Head louse, Pediculosis, DEET, Body louse, insect bites, permethrin