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Arthropod bite or sting in Infant/Neonate
See also in: Cellulitis DDx,External and Internal Eye
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Arthropod bite or sting in Infant/Neonate

See also in: Cellulitis DDx,External and Internal Eye
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Contributors: Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH
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Synopsis

An arthropod bite or sting may develop a localized inflammatory reaction manifested by localized swelling, redness, pain, burning, and pruritus.

Reactions may be more pronounced in the immunocompromised patient. An exaggerated, sometimes bullous reaction to an arthropod bite is characteristic of certain immunosuppressed states, especially a hematopoietic malignancy or HIV disease. In HIV-infected individuals, arthropod assaults may result in an extremely pruritic skin eruption called "pruritic papular eruption."

Arthropods include insects (stinging or venomous hymenoptera [eg, bees, wasps, fire ants] and non-venomous insects [eg, mosquitos, chiggers, fleas]) as well as ticks, mites, spiders, scabies, and body lice. Other arthropods often remain unidentified.

Arthropods may transmit human illness (including tick bite fever, Lyme disease, Rocky Mountain spotted fever, a variety of encephalitides, malaria). Venomous bites may trigger systemic toxic or allergic reactions, including anaphylaxis. An ascending paralysis caused by a neurotoxin may occur after a tick bite.

Some arthropod infestations, such as pediculosis capitis, scabies and crusted scabies, are highly contagious and pose a particular problem in the institutional setting.

There are highly variable global distributions of insects and arthropods. In returning travelers, insect bites are the fourth most common skin complaint diagnosed.

Codes

ICD10CM:
T63.481A – Toxic effect of venom of other arthropod, accidental (unintentional), first encounter

SNOMEDCT:
409981006 – Arthropod bite

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Differential Diagnosis & Pitfalls

Bullous reactions to arthropod bites (flea bites in particular) are often confused with bullous pemphigoid, bullous impetigo, linear IgA disease, and cutaneous mastocytosis. Tense bullae with a seasonal occurrence, a history of recent exposure to endemic areas, predilection for exposed sites, lack of significant surrounding inflammation, lack of systemic findings, and an absence of progression suggest arthropod bites over other diagnoses.

Urticarial / papular dermatoses: Vesicular / bullous dermatoses:

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Last Reviewed: 06/18/2018
Last Updated: 12/14/2018
Copyright © 2019 VisualDx®. All rights reserved.
Arthropod bite or sting in Infant/Neonate
See also in: Cellulitis DDx,External and Internal Eye
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Arthropod bite or sting : Bite or trauma site, Erythema, Eyelid edema, Scattered few, Pruritus, Excoriated papules
Clinical image of Arthropod bite or sting
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