August 8, 2014 - Eminent Dangers

As we approach the close of summer, silent predators surround us — some of them bizarre, some of them dangerous. 

Bug waving

A number of medical problems are more common during the warmer months and have the potential to be harmful or even life threatening if ignored.

It may be helpful to clarify the issues.

  • Truth or Fiction: Sunburns can be dangerous.
    • Sunburn is usually uncomfortable but not dangerous. However, if it involves a large surface area of the body, or if areas of 2nd degree burns or blistering develop, medical attention may be appropriate.
    • If nausea or vomiting accompany chills and fever, see your doctor immediately. This may be an indicator of sun poisoning, which is much more serious than a severe sunburn. Management often includes steroids and IV fluids, but rarely hospitalization is necessary if symptoms are ignored.
  • Truth or Fiction: Sunscreens protect us from all skin damage as long as the SPF is high enough.
    • This is true only to a degree. Sunscreens block much of the harmful UV radiation from the sun, but not those that can cause melanomas. This is one of the most dreaded and dangerous skin cancers. If it goes untreated, it is usually fatal.
    • The best prevention is limiting sun exposure. You can still tan, just don’t be extreme.
  • Truth or Fiction: Heat Stroke is just being uncomfortably hot.
    • Not true. Heat stroke is life threatening. If you become overheated, your body undergoes changes that cause you to lose heat, the most significant of which is sweating. Sweating cools our body core temperature, which is essential to staying alive. If you stop sweating because you’re dehydrated or your body is shutting down—you could die. It is imperative that you seek medical attention immediately, in an Urgent Care Facility or ER, or some place that has the capacity to offer IV fluids, body cooling, oral rehydration and other supportive measures.
  • Truth or Fiction: Insect stings are safe as long as they hurt when they happen.
    • This is a common misconception. Several complications can occur if you are stung (stinging requires a stinger—as in a bee, wasp or scorpion) or bit (biting requires a mandible—as in most spiders). Spiders that sting do not have a stinger—they have mandibles that inject venom. Uber creepy …
    • Most of the time, my patients present with a sore that looks like a sting, but don’t recall receiving one.
      • This usually means it wasn’t from a bee, wasp, hornet, scorpion (yes, they are common in Alabama), black widow, or fire ant—to name a few. They let us know when they sting because of the pain they inflict. But that leaves plenty of other bugs that can cause allergic reaction or infection—even cellulitis and abscesses.
        • Cellulitis is a severe inflammatory response of the skin to infection. It is a dangerous condition and should be taken seriously. Treatment requires the right antibiotics and potentially minor surgical intervention. See your doctor right away.
        • Allergic reactions to bites or stings usually cause a rash including urticaria or hives. This may be mildly to severely itchy. Over-the-counter Benadryl is a good start for anyone over 2 years of age, but seek medical attention as well. It could get worse and cause trouble breathing, a life threatening condition.
    • One thing to remember—any bite or sting can cause flesh damaging MRSA.
    • A bite always needs medical attention if:
      • It gets worse daily
      • Has an obvious abscess (pus pocket) associated with it
      • Is painful to light touch
      • You are running a fever
      • You feel extreme fatigue
    • It needs Emergency attention if:
      • It has a red streak from the sore toward the body. This is referred to as blood poisoning, and is a serious complication.

If you have a bite or sting that concerns you, get it checked by your medical provider.

Any tick bite should be evaluated with blood work if fatigue and/or fever develops anytime from 2-20 days after the bite.


Rocky Mountain Spotted Fever (RMSF) and Lyme disease are alive and well in Alabama, and many other parts of the country as well. In general, the smaller the tick, the more dangerous it is.

Do you have questions or comments? Please feel free to note them in the comment section below.