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Suggest Treatment For Swelling On The Leg After An Insect Bite

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Posted on Tue, 16 May 2017
Question: A person appears to have been bitten on the wrist ~52 hrs ago by a centipede. Approximately, a 3/4" deep, 1.5" wide, 2.5" long swelling developed by 28 hrs. She went to a doctor who iv'd antibiotics earlier today. This left side bite has been accompanied by entire leg swelling, also on the left side. I gave her 220 mg of naproxen two hrs ago, with intention of doing those at 3 or 4 x per day rate. She will be lying down and experimenting with elevating the leg soon. Uses an ice wrap for the bitten wrist occasionally.
From what I have read, a centipede bite should begin to taper off about now. She has option of seeing a cardiac or circulatory specialist tomorrow (aka 'CDC', what ever that is). There have been no respiratory issues these fifty plus hrs. Centipede bite is an educated guess. It is the only think I can thing would cause this severe a reaction from sitting on a lawn in XXXXXXX and placing one's hand in the wrong place at the wrong time. I'm aware that this could be an allergic reaction and could be more serious next time.
My questions are what might the left leg only swelling be about? and would 10 mg of baclofen every 4 hrs be helpful for anxiety (not much of a problem here) and pain relief?
doctor
Answered by Dr. Mahaveer Patil (1 hour later)
Brief Answer:
seems to be allergy

Detailed Answer:
Hi,

Thank you for posting the question.
I have gone through your medical history in detail.

From the symptoms it seems that the leg swelling is due to allergy for sure.

Only baclofen won't suffice.Anti allergic medications,proteolytic enzymes like trypsin,chymotrypsin or serratiopeptidase should be given in addition.

Application of magnesium sulphate / glycerine locally over the swelling 12 hourly with leg elevation will help reduce the swelling considerably.

Baclofen will give pain relief but would not be helpful for anxiety.
Anxiolytics need to be taken if the anxiety factor is considerable.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Kind regards.

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Mahaveer Patil (2 days later)
Dear Dr. XXXXXXX
Thank you for your answer. On further consideration of why she would have problems on the left wrist and the left leg, but not the right, I fixated on the fact that I had found her with drug injection paraphernalia a year ago. She had told me that she was cured of her addiction. However, when I challenged her about the syringe, spoon, and can that I found in her pack, she stuck to her insect bite story, saying that she had been injecting on the right side. I told her it was best to tell truth when going to a clinic, in order to avoid improper treatment, such as the antivenom. The swelling had subsided 36 hrs on and she left about 20 hrs ago. I mentioned her situation to a friend
doctor
Answered by Dr. Mahaveer Patil (1 hour later)
Brief Answer:
History is important

Detailed Answer:
I totally agree with you about the confusing history and symptoms.

Basically,the symptoms and clinical presentation do not exactly match the history given by the patient.

I would suggest a detailed face to face doctor-patient consultation to come to a proper diagnosis so that appropriate treatment can be initiated.

Thank you.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mahaveer Patil (37 hours later)
Hi Dr XXXXXXX
Patient says she is going into a suboxone detox program tomorrow.

My question is how the magnesium sulfate/glycerine is applied. What percentage MgSO4 is hand soaked in, for how long, and is it at 12 hr intervals.

Is the glycerine applied afterward? Can you substitute hand lotion?

Thank you XXXX
doctor
Answered by Dr. Mahaveer Patil (2 hours later)
Brief Answer:
note the procedure

Detailed Answer:
magnesium sulphate is in powder form.About 50 grams should be mixed with 20 ml of glycerine and applied gently every 12 hours.
For another hand lotion,i would suggest you to cunsult your family physician.

Thank you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
Answered by
Dr.
Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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Suggest Treatment For Swelling On The Leg After An Insect Bite

Brief Answer: seems to be allergy Detailed Answer: Hi, Thank you for posting the question. I have gone through your medical history in detail. From the symptoms it seems that the leg swelling is due to allergy for sure. Only baclofen won't suffice.Anti allergic medications,proteolytic enzymes like trypsin,chymotrypsin or serratiopeptidase should be given in addition. Application of magnesium sulphate / glycerine locally over the swelling 12 hourly with leg elevation will help reduce the swelling considerably. Baclofen will give pain relief but would not be helpful for anxiety. Anxiolytics need to be taken if the anxiety factor is considerable. I hope the answer was useful. Feel free to ask me any follow up queries that you may have. Thank you. Kind regards.