Comparison of moderate to severe systemic reactions with honeybee and wasp in children

The effect of the type of Hymenoptera on the severity of systemic reactions (SRs) is a controversial issue. The aim of the present study was to evaluate demographic, clinical, diagnostic, and therapeutic features of moderate-to-severe SRs in children with venom hypersensitivity and to compare the role of the honeybee and wasp stings in these reactions.

Data on children with moderate-to-severe SRs after a Hymenoptera sting were retrospectively collected for a 17-year period.

A total of 55 children with moderate-to-severe SRs (wasp: 44, honeybee: 11) to venom stings were included in the study. In the honeybee group, comorbid allergic rhinitis and any type of atopic disease was more frequent compared to the wasp group (p = 0.009 and p = 0.01, respectively). In 50.9% of the children, family history of SR to the same venom type was higher in the honeybee group (p = 0.02). Dyspnea was more frequent in the wasp, and cyanosis was more frequent in the honeybee compared to each other (p = 0.02 and p < 0.001, respectively). Prick tests results were significantly different between the groups (p = 0.038). There was no difference between honeybee and wasp in moderate-to-severe SR groups in terms of seasonal tendency, age at admission, age at first SR, gender, previous history of SR, sting localization, latency, and affected organ systems (p > 0.05 for each).

Moderate-to-severe SRs with honeybee and wasp venoms in children may differ in the severity of respiratory symptoms/signs at presentation, in addition to comorbidity of atopic diseases and family history of the SRs.