Insect Bites, Tick Bites, and Stings

  • Valeska Padovese
  • Federica Dassoni
  • Christos C. ZouboulisEmail author


Bites and stings typically result from an insect or tick trying to obtain a blood meal from a host. Clinically, they appear as erythematous papules that can be distributed singly, grouped, or generalized, depending on the amount of accessible skin and the number and type of the biting; a robust host response can produce bullae. Pruritus often results either as a direct result of the bite or as a host response to proteins injected into the skin by the insect. Stings involve the injection of venom into the victim and may cause reactions ranging from local irritation to life-threatening anaphylaxis. Although worldwide distributed, insects are numerous in humid hot climate zones, and, therefore, insect bite and sting-induced diseases commonly occur in dark skin populations. They are also common complains of visitors and returning travelers.


  1. 1.
    Singh S, Mann BK. Insect bite reactions. Indian J Dermatol Venereol Leprol. 2013;79:151–64.CrossRefPubMedGoogle Scholar
  2. 2.
    World Health Organization. 2016a.
  3. 3.
    Howitt P, Darzi A, Yang GZ, et al. Technologies for global health. Lancet. 2012;380:507–35.CrossRefPubMedGoogle Scholar
  4. 4.
    Manyando C, Kayentao K, D’Alessandro U, et al. A systematic review of the safety and efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria during pregnancy. Malar J. 2011;11:141.CrossRefGoogle Scholar
  5. 5.
    Rajapakse S, Rodrigo C, Fernando SD. Tafenoquine for preventing relapse in people with Plasmodium vivax malaria. Cochrane Database System Rev 2015;(4):CD010458.Google Scholar
  6. 6.
    Vasievich MP, Villarreal JD, Tomecki KJ. Got the travel bug? A review of common infections, infestations, bites, and stings among returning travelers. Am J Clin Dermatol. 2016;17:451–62.CrossRefPubMedGoogle Scholar
  7. 7.
    World Health Organization. 2016b.
  8. 8.
    Chen LH, Wilson ME. Dengue and chikungunya infections in travelers. Curr Opin Infect Dis. 2010;23:438–44.CrossRefPubMedGoogle Scholar
  9. 9.
    Wang L, Zhou P. Yellow fever virus: increasing imported cases in China. J Infect. 2016;73:377–80.CrossRefPubMedGoogle Scholar
  10. 10.
  11. 11.
    Chan M. Yellow fever: the resurgence of a forgotten disease. Lancet. 2016;387:2165–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Bae HG, Drosten C, Emmerich P, et al. Analysis of two imported cases of yellow fever infection from Ivory Coast and The Gambia to Germany and Belgium. J Clin Virol. 2005;33:274–80.CrossRefPubMedGoogle Scholar
  13. 13.
    Bautista-Reyes E, Núñez-Avellaneda D, Alonso-Palomares LA, et al. Chikungunya: Molecular aspects, clinical outcomes and pathogenesis. Rev Invest Clin. 2017;69:299–307.Google Scholar
  14. 14.
    Saiz JC, Vazquez-Calvo A, Blazquez AB, et al. Zika virus: the latest newcomer. Front Microbiol. 2016;7:496.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Feldmeier H, Heukelbach J, Ugbomoiko US, et al. Tungiasis—a neglected disease with many challenges for global public health. PLoS Negl Trop Dis. 2014;8:e3133.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Eisele M, Heukelbach J, Van Marck E, et al. Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: I. Natural history of tungiasis in man. Parasitol Res. 2003;90:87–99.PubMedGoogle Scholar
  17. 17.
    Karagiannidis I, Kanaki T, Brunner B, et al. Multiple, schwärzliche Papeln an beiden Fußsohlen einer 20-jährigen Patientin. Hautarzt. 2016;67:586–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Cestari TF, Pessato S, Ramos-e-Silva M. Tungiasis and myiasis. Clin Dermatol. 2007;25:158–64.CrossRefPubMedGoogle Scholar
  19. 19.
    Graves SR, Stenos J. Tick-borne infectious diseases in Australia. Med J Aust. 2017;206:320–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Song JH, Lee C, Chang WH, et al. Short-course doxycycline treatment versus conventional tetracycline therapy for scrub typhus: a multicenter randomized trial. Clin Infect Dis. 1995;21:506–10.CrossRefPubMedGoogle Scholar
  21. 21.
    Parola P: Rickettsioses in sub-Saharan Africa Ann NY Acad Sci 2006;1078:42–47.
  22. 22.
    Brouqui P, Harle JR, Delmont J, et al. African tick-bite fever. An imported spotless rickettsiosis. Arch Intern Med. 1997;157:119–24.CrossRefPubMedGoogle Scholar
  23. 23.
    Davies TG, Field LM, Williamson MS. The re-emergence of the bed bug as a nuisance pest: implications of resistance to the pyrethroid insecticides. Med Vet Entomol. 2012;26:241–54.CrossRefPubMedGoogle Scholar
  24. 24.
    Ibrahim O, Syed UM, Tomecki KJ. Bedbugs: helping your patient through an infestation. Cleve Clin J Med. 2017;84:207–11.CrossRefPubMedGoogle Scholar
  25. 25.
    Gbakima AA, Terry BC, Kanja F, et al. High prevalence of bedbugs Cimex hemipterus and Cimex lectularis in camps for internally displaced persons in Freetown, Sierra Leone: a pilot humanitarian investigation. West Afr J Med. 2002;21:268–71.PubMedGoogle Scholar
  26. 26.
    McMenaman KS, Gausche-Hill M. Cimex lectularius (“bed bugs”): recognition, management, and eradication. Pediatr Emerg Care. 2016;32:801–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Haddad V Jr, Amorim PC, Haddad WT, et al. Venomous and poisonous arthropods: identification, clinical manifestations of envenomation, and treatments used in human injuries. Rev Soc Bras Med Trop. 2015;48:650–7.CrossRefGoogle Scholar
  28. 28.
    Veraldi S, Cuka E, Gaiani F. Scolopendra bites: a report of two cases and review of the literature. Int J Dermatol. 2014;53:869–72.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Valeska Padovese
    • 1
  • Federica Dassoni
    • 2
  • Christos C. Zouboulis
    • 3
    Email author
  1. 1.Genito-Urinary Clinic, Mater Dei Hospital, Ministry of HealthMsidaMalta
  2. 2.Ospedale Alessandro ManzoniLeccoItaly
  3. 3.Departments of Dermatology, Venereology, Allergology and ImmunologyDessau Medical Center, Brandenburg Medical School Theodor FontaneDessauGermany

Personalised recommendations