Red flags and when to refer

Advise someone to see a GP if they present with an insect bite and the following:

• Signs and symptoms of infection, such as ongoing or worsening reddening of the skin, pain or fever
• A large local reaction or systemic reaction develops
• Their condition deteriorates
• They are systemically unwell
• They report severe pain which is significantly worse than the appearance of the wound, which may indicate the presence of toxin-producing bacteria.¹
• An immediate referral to a GP or A&E should be made if the person:
• Is suspected of having a systemic reaction to an insect bite or sting¹
• Has been stung on the face or mucus membranes and has difficulty breathing or is at risk of airway obstruction or compromised vision¹
• Shows symptoms of Lyme disease, which include a circular or oval rash, not usually hot or itchy, which can look like a bull’s eye on a dartboard
• Shows signs of malaria, which include a fever, sweats and chills, headaches and feeling confused and very tired, and the person has a history of foreign travel or reoccurring attacks
• Shows signs of cellulitis, which include painful, swollen and hot skin.