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Insect stings: clinical features and management.
Bernhard Przybilla1, Franziska Ruëff
1Clinic and Policlinic for Dermatology and Allergology, Ludwig-Maximilians-Universität, Munich. Bernhard.Przybilla@med.uni-muenchen.de
Deutsches Arzteblatt International
|April 26, 2012
Summary
Insect stings, from venomous insects or blood-sucking types, can cause severe allergic reactions, including life-threatening anaphylaxis. Specific immunotherapy is crucial for protecting individuals from future severe insect sting reactions.
Area of Science:
- Allergy and Immunology
- Toxicology
- Dermatology
Background:
- Local and systemic reactions in humans result from insect stings and bites.
- Common culprits in Central Europe include honeybees, wasps, mosquitoes, and flies.
Purpose of the Study:
- To review the clinical manifestations and management of reactions to insect stings and bites.
- To highlight the prevalence and severity of allergic responses to insect venom.
Main Methods:
- Selective literature review.
- Inclusion of national and international guidelines.
Main Results:
- Insect venom causes toxic reactions; allergies lead to large local reactions (up to 25%) and anaphylaxis (3.5%), with fatalities occurring annually.
- Mastocytosis increases risk for severe sting anaphylaxis.
- Blood-feeding insects elicit local allergic reactions (wheal/papule) in at least 75% of people.
Conclusions:
- Insect stings pose a significant risk for severe health outcomes, including anaphylaxis.
- Anaphylaxis from bee or wasp stings is common and requires management.
- Specific immunotherapy offers protection against severe, potentially fatal, insect sting reactions.
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