Summary

• Insects encounters are most prevalent in summer. Reactions range from local irritation and mild swelling to gross oral swelling and difficulty in breathing.
• Treatment is usually entirely supportive, aimed at alleviating immune reactions.
• Fatal spider bites are exceedingly rare. The majority can be treated with supportive care.
• Severe reactions and anaphylaxis require immediate treatment.
• Guidelines are mainly based on clinical experience and expert consensus, owing to the variability and unpredictability of reactions.
• There is risk of late-phase (delayed) anaphylactic reactions.
• Primary care physicians should be notified of severe reactions involving their patients.