Blistering in images

Insect bites and stings

In many cases, symptoms may be few, absent or can just cause itching. In others the reaction may be more severe resulting in swelling, inflamed papules, weals or blisters, as in this child who had spent the previous day playing in the garden. Secondary infection may occur, particularly if the lesion is scratched, leading to further swelling, inflammation, pain and enlargement of regional lymph nodes. Treatment with a systemic antibiotic such as flucloxacillin might be required or, if localised, topical fusidic acid may suffice. Some insects such as ticks and the Anopheles mosquito, can transmit diseases, such as Lyme disease and malaria, respectively. Some individuals might develop a hypersensitivity to insect saliva, venom, excretions or secretions, which can lead to anaphylaxis requiring immediate medical treatment with resuscitation measures and intramuscular adrenaline. Bees and wasps are the insects most likely to cause this and the vulnerable should be provided with an adrenaline autoinjector, for self use, should a similar problem arise in the future.