Photo Quiz Question – Q.004

Photo Quiz Question – Q.004 – August 5, 2011

23-year-old white male, who says he thinks he was stung by a bee while camping, but feels fine otherwise.

What does the above image depict?  Does he need a bee sting kit?  Is the patient contagious?

What should you do to prepare for a similar affliction?

To be honest, submit your response in the box below before turning to the answer.

The answer will be posted August 12, 2011 at:

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About Cynthia J. Koelker, MD

CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
This entry was posted in Bites-insect-bug-tick, Injuries, Medical archives, Perennial Favorites, Photo Quiz Questions, Rash, Skin, Skin infection, Symptoms and tagged , . Bookmark the permalink.

8 Responses to Photo Quiz Question – Q.004

  1. Marcus B says:

    I have 2600 blast bandages – still in date.
    I can get hundreds of 6″ Israeli bandeges – still in date.

    Next Thursday 7/18/2013 hundreds of Civil Defense survey meters will be sold at auction in Missouri.
    Also at auction are hundreds of dosimeter rechergers and thousands of dosimeters.

    Do you know of anyone interested in either of these types of things?

  2. Larry says:

    The bulls-eye rash tells it all: Lyme Disease.

  3. Michelle says:

    I have absolutely no idea. I would get a bee sting kit if he said he had a bee sting. Of course, I don’t know what a bee sting kit is either.

    I do not think he is contagious because the ring around the injury does indicate a sting.

    I would give him colloidal silver, sea salt and water, dried greens, coconut oil, vitamins and aloe vera, along with any fresh fruit and veggies I had.

  4. Kim says:

    To me, this appears to be a potential spider bite and possibly a Brown Recluse. He is not contagious, but needs antibiotics and if available, Silvadine (possibly misspelled) or colloidal silver applied topically to the bite area. If condition worsens, the affected immediate bite area needs to be surgically extracted to avoid further tissue loss and spread of infection.

  5. KF says:

    Looks like Lyme Disease with a developing cellulitis. This is a rather large initial area for Lyme’s. He is not contagious. He doesn’t need a bee sting kit. He needs long term antibiotics and supportive treatments if he develops other symptoms.

    I would measure the bulls-eye infected bite and the inner and outer 2nd ring of induration circumferences and recommend starting prophylaxis treatment of a long term doxycyline regime even if he has no other symptoms yet. Some people infected with Lyme never get any early symptoms. Early diagnosis and treatment is key to preventing severe debilitating symptoms later. Have the patient monitor the inflammation daily and report any early symptoms which develop which are flu-like: fatigue, achy muscles or joints, fever, chills, stiff neck, swollen glands, headache.

    The bacteria can lie dormant for weeks or years if untreated.

    Here’s is a list of common chronic Lyme symptoms:

    Brain and Central Nervous System: migraines, dizziness, brain fog, poor memory, poor sleep, lack of verbal fluency, confusion or disorientation, decreased ability to concentrate, facial nerve tics or paralysis, sore jaw, sinusitis, mood swings, difficulty chewing or swallowing, sore throat, hoarseness, muscle twitches, numbness and tingling, shooting pains, and lower back or neck pain. Lyme has also been found to mimic all the psychiatric disorders.

    Muscles, joints, and bones: pains that come and go (with or without swelling), cramps, stiffness.

    Circulation: too fast or two slow heart rate, irregular heartbeat (palpitations), inflammation of the heart muscle or arteries, and chest pain.

    Breathing: sinusitis, difficulty breathing, and pneumonia.

    Skin: rashes, itching, crawling sensations, benign cysts and nodules, and skin discoloration.

    Eyes: pain, inflammation, blurred or double vision, retinal damage, floaters, flashing lights, light sensitivity, dry eye, and blindness.

    Ears: itching, earache, buzzing, ringing, and sound sensitivity.

    Digestive tract: nausea, vomiting, diarrhea, constipation, loss of appetite, mild liver function abnormalities, and spleen tenderness and enlargement.

    Genitourinary tract: inflammation of the urethra and bladder, pelvic pain, testicular pain, and loss of sexual desire.

    General: tiredness, lack of stamina, fever, vague discomfort, irritability, nervousness or anxiety, and weight loss or gain.

    Borrelia is a brilliant bacterium that can avoid detection by the body’s immune system by changing shape, becoming cell-wall deficient (living inside red blood cells) or encysting over with albumin, which antibiotics can’t reach, and hiding out in a dormant state in hard to reach places like the spaces between ligaments and bones. Lab tests for Lyme’s is unreliable.

    If untreated or misdiagnosed, the Lyme spirochetes travel from the site of the bite to anywhere in the body via the skin, lymph system, and blood. They can ultimately cause problems in all body systems and even death.

  6. Chris MD says:

    Target lesion would strongly suggest Lyme disease. He would not be contagious (directly) and this would not be related to bee stings. Preparation would be to have antibiotic on hand (amox or doxy) but better to avoid tick bites using DEET-containing bug repellant and physical barriers (long sleeves, long pants), along with daily tick checks. They need to be attached 24 hrs to cause disease.

  7. farmerjohn75424 says:

    Believe its Lyme Disease, after I guessed I went looking and found a pic that matches

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