IMMEDIATE: Pain, often intense

LOCAL: 1-4 hours—A two-puncture wound at the site with redness, swelling, and a burning aching pain that subsides in 4-5 hours

REGIONAL: Rare—Purpura of an entire limb

ANAPHYLAXIS AND DEATH: None reported in the United States

TREATMENT

LOCAL FIRST AID:

1. Wash with soap and water 2. Apply ammonia in 10% solution 3. Apply cool wet dressings of a saturated magnesium sulfate solution

SYSTEMIC: Analgesics for pain

[TRUE BUGS (KISSING BUGS)]

REACTIONS