Which physical findings are characteristic of insect bites?

Updated: Jun 21, 2018
  • Author: Boyd (Bo) D Burns, DO, FACEP, FAAEM; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Without a clear patient history, diagnosis of an insect bite can be difficult since the initial response may be limited to erythema, local pain, pruritus, or edema.

Wheals and urticaria are common initial signs and generally appear within a few minutes of the bite. Unfortunately, many dermatologic conditions also produce similar cutaneous signs and may confound the diagnosis.

Identification of the insect responsible for the bite may be possible by examining the location, number, pattern, and sequelae of the bite(s).

Clinical criteria for diagnosis of anaphylaxis according to the World Allergy Organization are shown in the image below.

Insect Bites. World Allergy Organization anaphylax Insect Bites. World Allergy Organization anaphylaxis pocket card. Reprinted from The Journal of Allergy and Clinical Immunology, Vol 127, Issue 3, Simons FER et al, World Allergy Organization anaphylaxis guidelines; Summary, Pgs 587-93, March 2011, with permission from Elsevier. Available at http://www.jacionline.org/article/S0091-6749(11)00128-X/fulltext.

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