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

Arthropod bite or sting in Infant/Neonate

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

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:
409985002 – Arthropod bite wound

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Bullous reactions to arthropod bites (Flea bite in particular) are often confused with Bullous pemphigoid of childhood, Bullous impetigo , Linear IgA bullous dermatosis of childhood, and Diffuse 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:
  • Diffuse cutaneous mastocytosis (Urticaria pigmentosa or Mastocytoma)
  • Urticaria
  • Folliculitis
  • Pityriasis lichenoides et varioliformis acuta (PLEVA)
  • Lymphomatoid papulosis
  • Pseudolymphoma
  • Gianotti-Crosti syndrome (Gianotti-Crosti syndrome)
  • Cutaneous lymphoma / Leukemia cutis
  • Immunoglobulin A vasculitis (formerly Henoch-Schönlein purpura)
Vesicular / bullous dermatoses:
  • Diffuse cutaneous mastocytosis (Urticaria pigmentosa or Mastocytoma)
  • Bullous impetigo
  • Linear IgA bullous dermatosis of childhood
  • Varicella
  • Bullous pemphigoid of childhood
  • Acropustulosis of infancy
  • Erythema multiforme

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:06/17/2018
Last Updated:12/13/2018
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Patient Information for Arthropod bite or sting in Infant/Neonate
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Arthropod bite or sting in Infant/Neonate
See also in: Cellulitis DDx,External and Internal Eye
A medical illustration showing key findings of Arthropod bite or sting : Bite or trauma site, Erythema, Eyelid edema, Scattered few, Pruritus, Excoriated papules
Clinical image of Arthropod bite or sting - imageId=531756. Click to open in gallery.  caption: 'A close-up of two markedly edematous pink nodules on the buttock of an immunocompromised patient.'
A close-up of two markedly edematous pink nodules on the buttock of an immunocompromised patient.
Copyright © 2024 VisualDx®. All rights reserved.