The majority of bites and stings from terrestrial animals are not dangerous. However, due to their smaller size, children may be more susceptible to the effects of venom, and they may experience more-severe envenomation effects than adults. This issue reviews the basic epidemiology and underlying pathophysiology of the bites and stings of spiders, bees and wasps, fire ants, scorpions, snakes, and lizards. Clinical presentations are reviewed, and evidence-based recommendations are provided for management of the envenomated patient. While the pathophysiology and much of the presentation and treatment are similar for both children and adults, there can be subtle differences, which will be highlighted in this review.
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Following are the most informative references cited in this paper, as determined by the authors.
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Keywords: envenomation, pediatric envenomation, terrestrial envenomation, venom, antivenom, immunoglobulin G, IgG, Fc, Fab, F(ab’)2, anaphylactoid reaction, anaphylactic reaction, allergic reaction, sting, bite, spider, Latrodectus mactans, black widow, Loxosceles reclusa, brown recluse, Hymenoptera, Apidae, bee, honeybee, Africanized honeybee, bumblebee, Vespidae, vespid, yellow jacket, wasp, hornet, Formicidae, Solenopsis invicta, fire ant, scorpion, Centruroides sculpturatus, bark scorpion, Anascorp, snake, Crotalinae, pit viper, copperhead, cottonmouth, rattlesnake, CroFab, Anavip, Elapidae, coral snake, dry bite, lizars, Heloderma, Gila monster, beaded lizard
Michael Levine, MD, FACEP, FACMT; Nathan Friedman, MD
Sing-Yi Feng, MD; Nicole Gerber, MD
September 2, 2021
September 2, 2024
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 0.5 Trauma CME and 1 Pharmacology CME credits.