IMMEDIATE: Usually no sensation, occasionally mild pain
LOCAL: (Four distinct reactions depending on degree of sensitivity):
1. Papule with a central punctum 2. Small vesicles grouped around bite site with swelling and little redness 3. Giant urticarial lesion with central punctum and surrounding brawny edema 4. Hemorrhagic nodular-to-bullous lesions on hands and feet—the characteristic “kissing bug bites”
ANAPHYLACTIC SHOCK: Rare, but reported
DEATHS: None reported
TREATMENT
LOCAL FIRST AID: Wash with soap and water
SYSTEMIC: Oral antihistamines ([Chart 1])