When is hospitalization indicated for the treatment for 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

Patients with true anaphylaxis, particularly if associated with hypotension, often are admitted for monitoring or observation in the ED upon recovery. Accepted definition of "true" anaphylaxis requires the involvement of at least 2 of the following 4 systems: cardiovascular, gastrointestinal, skin, or respiratory; although newer guidelines indicate that hypotension only may be present after exposure to a known trigger. [13] Literature provides no clear direction on who needs admission. Certain patients with a disease transmission (eg, malaria) may require admission.

Corticosteroids and antihistamines usually are continued for a few (3-4) days after a systemic response. Serum sickness reactions may require longer therapy (see Serum Sickness).


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