Pediatric emergency medicine trisk 1806 1806

FIGURE 88.3 Insect bite in a child.

The distribution of lesions is a valuable clue in making the diagnosis of
mosquito or flea bites. Insect bites generally involve the exposed surfaces of the
head, face, and extremities. The lesions are usually urticarial papules that occur in
groups or along a line on which the insect was crawling. Some lesions may
manifest a central punctum. On occasion, both mosquito bites and flea bites can
cause blistering lesions. These lesions are not indicative of secondary infection
but rather represent an immune response to the bite.
Excoriation with resulting secondary infection with Staphylococcus aureus or
Group A streptococci can complicate a simple bite. Because swelling and redness