Oropharyngeal hymenoptera stings: a special concern for airway obstruction

Hymenoptera stings are common and cause 40 to 50 deaths each year. Hymenoptera venom contains a variety of toxic and allergenic substances that can produce many types of both local and systemic reactions. Of these, anaphylaxis is the most feared and the most common cause of sting-related deaths. Oropharyngeal stings, although rare, have the added potential to produce life-threatening airway obstruction via localized swelling. This threat is of particular concern to military personnel who operate in environments where stings are more likely to occur and where emergency medical resources are limited or lacking. This risk can be minimized if such victims are treated early and aggressively, even though they may initially present with minimal symptoms.