小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 有证据的咬伤/蜇伤
- 局部水肿
- 局部疼痛
- 局部温暖
- 局部印记
- 瘙痒
- 风疹块和潮红
- 皮肤苍白
- 皮肤湿冷
- 气道损伤的体征
- 口咽部水肿
- 呼吸困难
- 啰音/湿罗音/喘鸣
- 心动过速
- 脉搏不规则
- 皮肤潮红
- 警觉性改变
其他诊断因素
- 脓疱
- 靶心状皮疹
- 手掌和脚掌皮疹
- 线状凸起皮疹
- 高血压
- 发热
- 肌肉痉挛
- 发汗
- 震颤
- 感觉异常和/或肌束震颤
- 全身疼痛
- 恶心/呕吐
- 头痛
- 腹痛
- 免疫功能不全状态史
- 心血管疾病史
- 脓肿
- 坏死
- 咳嗽
- 低血压
- 关节痛
- 淋巴结肿大
危险因素
- 职业或娱乐活动中接触到昆虫
- 地域性昆虫接触
- 过敏(或过敏样)反应既往史
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 全血细胞计数 (FBC)
- 血清纤维蛋白溶酶
- 敏感性试验
治疗流程
过敏/过敏样反应
局部反应
继发性感染:免疫功能正常;MRSA 风险较低
撰稿人
作者
Tom Morrissey, MD, PhD
![Tom Morrissey](/api/image/281/zh-cn/normal/281-auth-1_default.jpg)
Associate Professor
Department of Emergency Medicine
University of Florida
Jacksonville
FL
利益声明
TM declares that he has no competing interests.
鸣谢
Tom Morrissey would like to gratefully acknowledge the assistance of Richard Vetter (MS) from the Department of Urban Entomology at the University of California.
利益声明
Not disclosed.
同行评议者
Theodore M. Freeman, MD
Allergist and Immunologist
Jacobs Ramirez and Freeman Allergy & Immunology
San Antonio
TX
利益声明
TMF is an author of a number of references cited in this topic.
Andrew Parfitt, MBBS, FFAEM
Clinical Director
Acute Medicine
Associate Medical Director
Consultant Emergency Medicine
Guy's and St Thomas' NHS Foundation Trust
Clinical Lead and Consultant
Accident Emergency Medicine
St Thomas' Hospital
London
UK
利益声明
AP declares that he has no competing interests.
Richard DeShazo, MD
Chairman and Professor
Department of Medicine
Professor of Pediatrics
Billy S. Guyton Distinguished Professor
University of Mississippi Medical Center
Jackson
MS
利益声明
RD is an author of a reference cited in this topic.
鉴别诊断
- 蜂窝织炎
- 眶周和眼眶蜂窝织炎
- 脓肿
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