Bites and stings of Hymenoptera, caterpillar and beetle

Insects compose a very large group of creatures that bite or sting but only a few are truly venomous in the sense that they inject a venom into human victims. Anaphylaxis from a Hymenoptera sting is the most serious reaction from this group and is estimated to account for approximately half of the annual fatalities from venomous bites and stings in the United States. Epinephrine, Benadryl, steroids, hyposensitization, local tissue management and symptomatic and supportive care are discussed.