Stings and bites from insects are common, especially during the summertime. They often result in redness and swelling around the affected area. Sometimes, however, a sting or bite can cause a life-threatening allergic reaction.

Symptoms

A child’s response to a sting or bite from an insect can vary and depends on a variety of factors. Most bites and stings result in pain, swelling, redness and itching to the affected area. If scratched, the skin may be broken and become infected. If not treated properly, these local infections may become severe and cause a condition known as cellulitis.

If a child is allergic, he or she may experience a severe reaction beyond the immediate area of the sting or bite. Symptoms of a severe reaction include hives, wheezing, shortness of breath, unconsciousness, and in the worst cases, death within 30 minutes.

A sting or bite on the tongue or throat may cause throat swelling and death because of airway obstruction.

Stings from large hornets or multiple (hundreds or thousands) bee stings have been reported, although rarely, to cause muscle breakdown and kidney failure.

Bites from a fire ant typically produce a pustule—a pimple-like sore—that is extremely itchy and painful.

What to do

Treating an insect sting or bite really depends on the type of reaction your child has. If there is only redness and pain, simply applying ice and gentle reassurance can be more than enough. Be sure, however, to clean the area with soap and water to remove contaminated particles left behind by some insects (such as mosquitoes, if they were slapped) because these particles could contaminate the wound.

While sometimes difficult, you need to ask the child not to scratch the wound, because this only makes it worse. Scratching can cause the skin to break down, and this can lead to an infection. If the bite or sting becomes infected and shows signs of redness (with or without pus), warmth, fever or a red streak that spreads toward the body you need to seek medical treatment.

To help reduce the itchiness of the wound you can treat itching at the site of the sting or bite with an over-the-counter antihistamine such as diphenhydramine (commonly known by its trade name Benadryl), which comes in a cream, an ointment and a pill form. Use either the Benadryl in the liquid/pill OR the cream, but not both. Calamine lotion also helps relieve itching.

If you don't know what bit or stung your child, it is important to keep watching the area closely to be sure it does not become infected. Call your doctor if there is an open wound, which may suggest a poisonous spider bite.

If your child is allergic

If your child starts to experience symptoms that are not just at the site of the bite or sting, you should seek medical attention. These symptoms (systemic symptoms affect the whole body) may progress to a fatal condition called anaphylactic shock.

Hives are the most common systemic symptom. They appear as irregular, raised, red blotchy areas on the skin and are very itchy. If hives are the only systemic symptom present, they are often treated at home with an antihistamine.

Children who have a history of severe reactions should go to the nearest hospital emergency department after a bite or sting if they experience any symptoms. Those who have no history of severe reactions should also go to the emergency department if they have any of the following symptoms:

• Wheezing
• Shortness of breath
• Chest tightness or pain
• Sensation of the throat closing or difficulty speaking or swallowing
• Faintness or weakness
• Infection

THIS ARTICLE IS NOT INTENDED AS MEDICAL ADVICE. PLEASE BE SURE TO SEEK THE ADVICE OF A LICENSED MEDICAL PROFESSIONAL BEFORE ADMINISTERING ANY MEDICAL CARE.