An area of erythema and edema may surround the site of a wasp or hornet sting. It can be a challenge to determine the underlying process.
Differential diagnosis of erythema and edema around the site of a wasp or hornet sting:
(1) cellulitis due to aerorbic or anaerobic bacteria
(2) cellulitis due to mycobacteria
(3) exaggerated local reaction due to venom toxin
(4) eosinophilic cellulitis
Cellulitis may be associated warm and tender. Culture may be positive provided the right specimen and culture media are used. If the infection progesses then the patient may become febrile and/or septic.
Failure to respond to broad spectrum antibiotics suggests:
(1) a process other than bacterial cellulitis.
(2) an organism like Pseudomonas that is resistant
(3) mycobacterial infection
Response to systemic corticosteroids suggests eosinophilic cellulitis.
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