A bee sting can be anything from a mild annoyance to a life-threatening injury. Besides the well-known side effects of a bee sting, it’s important to watch out for infection. Although infections are rare, a bee sting may be infected even if it appears to be healing. The infection might be delayed for days or even weeks.

When you’re stung by a honeybee or bumble bee, it’s important to remove the stinger and venom sack without pushing and injecting more venom under the skin. Pushing the stinger in deeper can also increase the risk of infection. Here’s what you need to know about what to watch for, how to treat a sting and possible infection, when to call a doctor, and more.

The sting itself is usually painful. The venom can cause swelling and still more pain, though usually not more than can be handled with cold compresses and an over-the-counter pain reliever.

Redness and swelling are common at the site of any bee sting. These don’t necessarily mean infection. In fact, a bee sting rarely becomes infected.

When infection does occur, the signs are the same as for most infections. Symptoms can include:

  • swelling
  • redness
  • drainage of pus
  • fever
  • pain
  • malaise
  • chills

Trouble swallowing and breathing as well as swelling of the lymph vessels have also been associated with a bee sting infection.

Symptoms might appear 2 to 3 days after the sting. In one report, the signs appeared just under two weeks after the sting.

Emergency symptoms

Anaphylaxis is the most widely known severe reaction to a bee sting. In a small number of people, the bee venom can send them into shock. With shock, your blood pressure drops and breathing becomes difficult. The correct response is a shot of epinephrine and an immediate trip to the hospital emergency department.

How a bee sting might produce an infection is unclear. Bees are structurally complicated. They may pick up infectious organisms and pass them along when injecting venom. When you’re stung, the stinger remains in you and even continues to burrow after the sting, increasing the chance of introducing an infection.

Because infections related to bee stings are so rare, most of the knowledge about them comes from case reports of single individuals. For example, a paper in Clinical Infectious Diseases reports that a 71-year-old man died after being stung by a bee. The autopsy indicated the presence of Streptococcus pyogenes bacteria. In another report, a bee sting to the eye introduced an infection to the cornea. A culture four days after the sting produced the bacterial organisms Acinetobacter lwoffii and Pseudomonas.

Another study looked at infected bites and stings — not exclusively bee stings — treated in emergency departments. Methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MRSA) were the cause of about three-fourths of the infections.

Any weakness in your immune system puts you at greater risk of an infection after getting stung by a bee. Tell your healthcare provider if you have any condition that lowers your immunity. Any untreated infection can produce significant complications and even death. It is important to seek medical attention for anything other than an uncomplicated sting.

Seek medical help for any sting that produces a large, local reaction or increasing pain. It may or may not mean an infection. Sometimes, a severe reaction can mimic infection.

A doctor may culture any discharge from the site to help determine if an infection is present. The symptoms may be enough for a doctor to prescribe antibiotics, even without a culture.

You can treat a large, local reaction by elevating the area, applying cold compresses, and taking nonsteroidal anti-inflammatory drugs, or NSAIDs, for pain. If the reaction includes itching, antihistamines might help. For severe swelling, your doctor may suggest oral prednisone for 2 or 3 days.

Sting infections are treated according to the specific infecting organism. For example, the eye trauma described above was treated with two days’ worth of hourly eye drops of cefazolin and gentamicin, then prednisone eye drops.

For S. aureus, infections should be treated with oral antistaphylococcal penicillins. People who are sensitive to penicillin may be given tetracyclines. MRSA infections should be treated with trimethoprim-sulfamethoxazole, clindamycin, or doxycycline.

Treatment to prevent tetanus is not warranted in the case of bee stings.

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An infection is likely to clear up within a few days. Your doctor will give you specifics on what to expect and what to do in the event the infection lasts longer than expected. Unless you have some type of immune system weakness, you have no particular risk of an infection if you get stung again.

Simple steps can help reduce the risk of a problem after a bee sting.

Preventing complications

  • Seek help. You will need it if the sting produces an allergic reaction.
  • Wash the sting site with soap and water.
  • Remove the stinger using gauze wiped over the area or by scraping a fingernail over the area. Don’t prod the stinger or use tweezers, which might force the venom further under the skin.
  • Apply ice.
  • Don’t scratch the sting, as this may increase swelling, itching, and risk of infection.
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