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Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Is My Bee Sting Infected?

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Bee and Wasp Stings : Picture of Sting on the Arm
A reader asks (about a bee or wasp sting): “How do I know if it’s infected and that I need antibiotics?”

As you can see from the previous post, a bee or wasp sting can cause a skin reaction with redness, swelling, itching, and pain. This is very similar to the appearance of skin that is inflamed by a bacterial infection - a condition sometimes referred to as cellulitis. A wasp sting may also cause blistering with or without "brawny" swelling, which is when the skin feels thickened, warm, and bumpy to the touch. Either a sting or an infection can cause lymph nodes ("glands") that drain the region to become swollen and tender.

So, the determination of an infection becomes a judgment call. Infection following a sting usually develops 48 to 72 hours after the sting, so if someone has suffered a sting, appears to be improving, then has his or her condition deteriorate, infection should be suspected. Fever can be present with a sting or an infection, but is more common with an infection. If the area of skin initially affected by the skin seems to be stable for a few days, then begins to spread, particularly if there is any reddish streaking traveling up an arm or leg towards the heart, increasing skin warmth, or increasing skin tenderness, that may indicate an infection. If any liquid leaks from the site of the sting, particularly if it appears cloudy or thickened, like pus, one should suspect an infection. If the wound develops a crunchy or "Rice Krispies" feel to it, that is a medical emergency, because it may represent the formation of gas from a severe infection.

If an infection is diagnosed or highly suspected, the treating medical professional will usually recommend antibiotics. Sometimes, it is impossible to determine if the skin reaction represents the effects of the venom or an infection that has subsequently developed. In that case, your doctor may decide to treat you both for the toxic-allergic component, as well as for a possible infection. Finally, always remember to keep your immunization against tetanus up to date.

photo of non-infected wasp sting by Paul Auerbach

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Tags: Bites & Stings

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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