Insect Bites
By Charles H Geneslaw, MD
May 11, 2018
Category: Uncategorized
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Now that we can finally enjoy spring weather and anticipate summer sunshine, I’m seeing more insect bites of late.  Let’s review a few basic concepts.

First, generally one insect’s bite looks much like the next–red, itchy bumps; there are only a few species who confer a bite with specific appearance.  Often there is swelling initially that usually dissipates within 24 hours or so; swelling in that time frame usually does not suggest infection.  Typically cold compresses and benadryl for itch is all that is needed here.  Keep fingernails trimmed so any scratching is done by blunt fingertips and not sharp nails to limit promoting infection.  Infections are different–firstly, usually, they hurt.  Moreover, if we think about an infection “growing”–somewhat like a plant–then we can understand the GERMS as akin to SEEDS that must GERMINATE.  In other words, like a plant that takes time to grow after the seeds are planted, the infection will take some period of time to “grow”(incubate)–generally 3-4 days–for the infection to develop.  So the usual progression is bite, swelling, improving, then 3-4 days later renewed swelling, redness and pain at the site.  So the former usually does not require any medicine and the latter may well require a course of antibiotics.  Those lesions associated with fever, blisters, pus, or red streak growing towards the body may be more serious and could require IV treatment.

Tick bites are a special case. I have covered them before.  If you find an embedded tick it should be promptly pulled out INCLUDING THE HEAD with a tweezers.  Don’t waste time trying to cover it with vaseline, other caustic agents, or burning it with a match.  Clean the wound off with the best antiseptic in the house(for any open wound)–soap and water.  It is allowable, although not essential in my opinion, to have the live tick tested.  There are limited circumstances under which preventive treatment is indicated and they do not involve identifying lyme in the tick. Note that one does not have to develop the classic “bull’s eye” rash to develop lyme disease, and that the symptoms of lyme infection are specific and well defined–it isn’t just joint aches, headaches, and tired all the time

Finally–prevention.  The best approach is avoidance.  Stay away from standing water (chemically treated pool does not count here)or thick vegetation early or late on summer days when and where insects are most active. Avoid walking in high grass or thickly wooded areas and wear long sleeves and pants if you do; generally better to dress in long sleeves and pants outside anyway if weather permits.  Insect repellent on bare skin is fine; reapply every few hours for prolonged exposure–just wash it off as soon as possible.

But its the spring, so get the heck out there and have fun.  Thanks for following.

 
 

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