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Horsefly (genus Tabanus) bite: allergy or infection?
  1. Katherine Kelly and
  2. Pauline Grose
  1. General Medicine, Glasgow Royal Infirmary, Glasgow, UK
  1. Correspondence to Dr Katherine Kelly; katherine.kelly3{at}


Summer heatwaves are often associated with increased reports of insect bites as people enjoy spending time outdoors. The horsefly (genus Tabanus), or ‘cleg’ as it is colloquially known, often receives negative publicity due to peak activity in summer. Following an increase in local hospital presentations due to complications of bites, discussion among colleagues suggested a lack of knowledge regarding best management.

We present a case of a woman in her 30s with a large erythematous swelling on her thigh following a suspected horsefly bite. Review revealed no clinical evidence of sepsis but a localised inflammatory response. Inflammatory markers were normal and she was treated with intravenous antibiotics and oral antihistamines to good effect.

This case highlights secondary care presentation of a common condition and discusses potential complications, pathogenesis and uncertainties around best practice guidelines for treatment. We highlight strategies to aid antibiotic stewardship, reduce complications and secondary care presentation.

  • Skin
  • Infectious diseases
  • Dermatology

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  • Contributors KK: Internal medical trainee—submitting author, involved in patient care and writing of the case report. PG: Consultant Acute Physician—supervising consultant for patient care plus reviewing and editing case report Patient—Reviewed case report and provided her perspective.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.