Pediatric envenomations: don't get bitten by an unclear plan of care.

Children are frequently victims of terrestrial animal and insect bites and stings. While the majority of these bites or stings are nondangerous, pediatric patients occasionally encounter a venomous animal. In such cases, children may present to the emergency department for evaluation and management. This review presents the basic epidemiology of bites and stings of spiders, bees and wasps, fire ants, scorpions, and snakes, but it primarily focuses on the underlying pathophysiology and clinical presentation of the envenomated patient. While the pathophysiology and much of the presentation and treatment are the same for both children and adults, there are occasionally subtle differences, which will be highlighted. The management and disposition of pediatric patients for each type of bite or sting will also be discussed.