-IBIS-1.5.0-
tx
cutaneous system
bite: animal/insect
diagnoses
definition and etiology
definition:
puncture, abrasion or laceration of the skin or other tissue by animals or insects
etiology: Dog and other animal bites are a vehicle for bacterial infection. A major concern is rabies or hydrophobia, an infectious disease of mammals that involves CNS irritation followed by paralysis and death. Wounds should be carefully cleaned. If a dog or cat bites a human, the current method of differential diagnosis is to isolate the animal for 10 days. If no symptoms arise, the animal is considered not to have been infected.
signs and symptoms
signs and symptoms:
centipedes & millipedes: painful bite which causes local pain and erythema; some necrosis of tissue may ensue; some non-USA species spray a toxic compound which can cause severe conjunctival reactions
scorpions: relatively harmless, causing pain and numbness; if centruroides sculpturatus, expect numbness, tingling and pain over the involved part; weakness of the extremity, respiratory difficulties (especially in children), and hypertensive crisis can occur; contact poison control center and observe patient for 24 hours
bees, wasps, hornets, ants: if stung by many bees (about 100, if one is counting), a lethal dose of venom may be injected, but death is usually from anaphylaxis in a hypersensitive person. Hypersensitive people may carry a kit containing antihistamine and epinephrine.
ticks: vectors for various diseases, including Lyme disease; bitten area should be cleansed. If the tick is adhered, it should be irritated with a petroleum product or the head of a match recently blown out. Care should be taken to make sure the head is not left in the skin.
spiders: Nearly all spiders are venomous. Most, however, cannot kill humans because of short, fragile fangs.
» black widow spider (latrodectus) bites cause sharp pain and muscular rigidity in the abdomen, arms, and back; pain upon inspiration; headache; dizziness; and increased perspiration
» brown recluse (loxosceles) gives rise to little pain; enzymatic reaction can be severe and cause localized necrosis
dog: cleanse bite wound with strong detergent; administer antirabies serum if there is any suspicion of rabies or on first sign of symptoms; observe dog in isolation for 10 days for signs of the disease
snake: determine type and obtain antivenom if the snake is poisonous; poisonous snakes in the U.S. are coral snake, copperhead, water moccasin, rattlesnake (15 species)
lab findings:
nonspecific unless secondary infection occurs
spider bites can cause eosinophilia and leukocytosis
course and prognosis
Depends on the type and severity. Most involve only tissue damage or local inflammation. Few insect bites are fatal, but a hypersensitive individual may experience an anaphylactic reaction which can cause death.
differential diagnosis
If the culprit of a severe bite is not identified, the patient should be observed for 24 hours and possibly hospitalized.
footnotes