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When a doctor says “Look for a red line from a bee sting” what exactly does that look like?
My son, Colby, recently got stung by a bee. He’s been stung before, but this one was different. His hand swelled incredibly, and when I called our pediatrician’s nurse advice line, they warned about a red line going up the arm that would indicate infection. Hours later, I wondered “Is that a line?” I hit up Google images but couldn’t find anything that showed photos and gave an outcome (I found photos of lines, of other people asking, “Is this a red line?” But none answered the question.) So… this blog post. Maybe you’ve found this post because you, too, need to know “Is that a line?”
It started here: a field of purple flowers near Eugene, Oregon. We were dropping my daughter off at a church camp in mid-May and the flowers were gloriously in full bloom. We noticed the bee boxes lining the field. Twenty minutes later, 1/4 mile away, my son put his hand on a fence post and felt the unmistakable sting of a bee. None of us saw the bee, though, so we can’t be sure it whether it was a bee or a yellow jacket. While I took my daughter to her cabin, my husband took our son to the nurse’s shack for some ice. End of story, so we thought.
Swelling and Fever
Since Colby was still feeling puny, I gave him some ibuprofen and called the nurse advice line at our pediatrician’s office. She suggested buying some oral Benadryl just in case it was an allergic reaction. She also warned me to watch for a red line on his arm that would indicate infection. Meanwhile, Colby fell asleep, something he never does in the middle of the day.
Is that a red line?
I ran back to Walgreens to buy the oral Benadryl. When I got home, our son was awake. His hand was now so swollen that he couldn’t bend any of his fingers even a little, and it was hot to the touch. And…was that a line? What does a line even look like?
I took this photo outside in natural light, then hit Google looking for photos of “red line on skin” and “blood poisoning red line”. I couldn’t find a single photo or post that gave me the answers I needed. Next, I texted the photo to my mom. When I was little, she was bit by a spider, and I remembered her story of the infamous red line. My husband and I had no idea what such a line would look like. Was this barely-there mark a line?
My mom didn’t text back. She called.
“ER. Go now.”
I was a little sheepish checking into the ER: “I don’t know if this counts as a red line, but my mom said to come in.” The nurse behind the desk took one look and immediately ushered us back to triage. I took these photos in triage.
Triage took some basic vital signs, including his temperature, which was normal. They sent us from triage to the waiting room.
We sat in the waiting room for less than 5 minutes. They called his name first, before all of the people who were already waiting. A nurse settled him into a room and within moments, a doctor arrived. Things happened fast. That subtle red mark was indeed a line, and by now it was to his armpit, and was pooling in the armpit.
First, they piled ice onto his hand to relieve swelling, which was now threatening to split the skin. And his skin was so hot. On his other arm, they smeared a cream to numb the skin to prepare for an IV. By now, he felt really lousy. The nurse came in, over and over and over, to take his vitals, including temperature. The doctor also came in every few minutes.
Diagnosis: Staph Infection
The nurse put in an IV as the doctor watched. The doctor explained that our son was having a severe infection due to the sting. Blood poisoning. Staph. They were going to give powerful antibiotics intravenously to combat the infection before it reached his heart. And, the doctor said, he’s also allergic to bees. The infection and allergy were unrelated to one another, he thought, but both needed immediate treatment. So, they also added massive doses of Benadryl to the IV.
As the IV dripped, the nurse sat with us a while. Colby was miserable by that point and didn’t want to even watch movies. She explained that his temperature had spiked, and he’d been running an increasingly higher fever while in the ER. His blood pressure was also dropping, so they’d put an automatic cuff on him that took his blood pressure every 3 minutes. These are both signs of sepsis, meaning the infection was spreading to his whole body.
Thankfully, our story has a good ending. After about 3 hours, his temp and blood pressure returned to normal and he started feeling a little better. The red line disappeared. The doctor prescribed oral antibiotics and an epipen. The antibiotics are for the infection, which he doesn’t thing is likely to happen again. That hopefully is a once-in-a-lifetime event. The epipen is for the allergy, which will almost certainly happen again as we’re an outdoor family and my kids each get stung about once a year. This particular episode wasn’t respiratory, but any future sting could be, so we have the pen for camping trips and hiking trips when we’re away from medical care. Otherwise, we carry Benadryl with us everywhere, and it’s stocked at school. Should he ever get stung again, an immediate dose of Benadryl is his best defense against a serious reaction.
If you see a red line from a bee sting…
The next day, his hand was completely back to normal size, and he felt fine. The hospital discharge papers said he’d gotten a staph infection in his bloodstream due to a bee sting. Probably, the staph was already on his hand when he was stung. The bee sting was just the method for it to enter the bloodstream. Can happen anytime, to anyone, from any skin prick. If you see a red line, a pink line, a barely-there-maybe line, GO. This infection moved so fast in our son, if my mom wasn’t familiar with a “red line”, I’m afraid things would have turned out much worse. I’d would never have taken him to the ER for something so subtle. I’m putting this post out there in the hopes of answering that question for someone else.
For more information
For more information on red lines from bee stings and also allergic reactions, here are some reputable sources:
Mayo Clinic – how to tell when you need care for an allergic reaction.
Riley Children’s Health – 4 things to do when your child is stung.
St Louis Children’s Hospital – when to seek treatment when your child is stung.