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Other Arthropod Bites

by Robert A. Barish, MD, MBA, Thomas Arnold, MD

The more common biting non-tick arthropods in the US include sand flies, horseflies, deerflies, blackflies, stable flies, mosquitoes, fleas, kissing bugs, lice (see Lice), bedbugs, wheel bugs, and certain water bugs. All of these arthropods, except wheel bugs and water bugs, also suck blood, but none is venomous. Disease transmission is the main concern related to mosquito bites. Mosquitoes may transmit chikungunya virus, dengue (see Dengue), some types of encephalitis (see Table: Some Arboviral Encephalitides in the US), malaria (see Malaria), and yellow fever (see Yellow Fever).

Arthropod saliva composition varies considerably, and the lesions caused by bites vary from small papules to large ulcers with swelling and acute pain. Dermatitis may also occur. Most serious consequences result from secondary infection or hypersensitivity reactions, which can be fatal in sensitized people. Flea allergens may trigger respiratory allergy even without a bite in some people.

The location and pattern of wheals and lesions are sometimes diagnostic of the bite source. For example, blackfly bites are usually on the neck, ears, and face; flea bites may be numerous, mostly on the feet and legs; and bedbug bites often occur in linear patterns, most commonly on the torso.

The bite should be cleaned, and an antihistamine or corticosteroid cream or ointment should be applied for itching. Severe hypersensitivity reactions should be treated (see Atopic and Allergic Disorders : Treatment).

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