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4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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Treatment Details

Bees and Wasps

Honey bees have a barbed stinger which contains two lancets which become firmly attached to human skin. The stinger of the wasp does not have barbs. Fire ants have well developed abdominal stingers. They are commonly seen in mango trees. Bees leave their sting behind and can only sting once, but wasps and hornets do not leave their stings behind and can sting many times. Bee venom contains dopamine, histamine, neurotoxin, enzymes and toxic peptides. Wasp venom contains serotonin in addition. Ant venom mainly contains alkaloids and proteins.

Route : Injection

Mechanism of action : Hypersensitivity reaction

Clinical picture : Painful and sometimes fatal reactions occur in humans. The reactions are usually local. Severe systemic reactions are not common. The local reaction consists of pain, redness and slight swelling at the site of the sting. Stings of the mouth, throat and sometimes of the face, neck or limbs cause oedema of the larynx or pharynx and obstruction.
Systemic toxic reactions occur due to multiple stings. There is gastrointestinal disturbance and shock. Vomiting and diarrhoea may be accompanied by faintness and unconsciousness. The attack lasts for 24 hours if not fatal.
The anaphylactic reaction may occur immediately or within 20 minutes. There is respiratory distress, faintness and unconsciousness. A rash may develop. Death may occur within 2 to 15 minutes.

Treatment : 1} Apply a ligature above the site of the sting and incise it.
2} The sting should be located and removed by tweezers.
3} Tincture of iodine or local application of antihistamine is useful.
4} Adrenaline is given to combat systemic reactions.
5} ACTH 25 mg. in a litre of normal saline is given by intravenous infusion.
6} Calcium intravenously is useful for urticaria.

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

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