The term “bug bite” is commonly used to denote both bites and stings inflicted by members of the phylum Arthropoda.  Arthropods make up the largest division of the animal kingdom, representing approximately 80% of all known animals. Defining characteristics include the presence of an exoskeleton, jointed appendages, and a body composed of specialized regional segments.

The four medically significant classes of arthropods are Chilopoda, Diplopoda, Insecta, and Arachnida. Of these, the insects, which represent more than half of all living organisms, and the arachnids have the greatest clinical impact on humans.

Erythematous and edematous eruptions along with other dermatological findings such as papules and urticaria represent the most common clinical manifestations of arthropod bites and stings.  In some cases, the delivery of toxic venom can result in significant systemic reactions including autonomic instability, neurotoxicity and organ failure.  The acute development of anaphylactic reactions can be rapidly fatal, most commonly due to angioedema or circulatory collapse.  In these cases, rapid recognition and treatment with epinephrine are critical.  The most clinically significant impact of arthropod bites is their ability to serve as vectors for numerous bacterial, viral, and protozoal diseases.

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Etiology

The consequences of arthropod bites are generally due to traumatic injury or local inflammation and hypersensitivity to arthropod saliva. Even though some arthropods are capable of injecting venom when biting, most envenomation occurs via a stinger connected to a venom gland.  Notable arthropods possessing stingers include bees, wasps, hornets, fire ants, and scorpions.  Both bites and stings create tissue injury which can serve as a portal of entry for secondary bacterial infection.

The four classes medically significant arthropods are the chilopods, diplopods, insects, and arachnids.

Chilopods

Diplopods

• Topical antibiotics and analgesics for topical exposure
• For ocular exposure: copious irrigation, fluorescein staining, topical antibiotics, cycloplegics, and ophthalmology referral |

Insecta

Members of the class Insecta, which comprise approximately 60% of all arthropod species, include Hymenoptera (bees, wasps, hornets and fire ants), mosquitoes, bed bugs, fleas, lice, beetles, caterpillars and moths, and kissing bugs.