Hymenoptera stings: Difference between revisions
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==Class Hymenoptera== | ==Class Hymenoptera== | ||
;Subgroups | |||
#Bees | #Bees | ||
#Wasps | #Wasps | ||
# | #Ants | ||
* | *All Hymenoptera share similar components in their venonm and patients can have allergies across the subgroups<ref name="King">King TP et al. Structure and biology of stinging insect venom allergens. Int Arch Allergy Immunol. 2000;123(2):99-106</ref> | ||
*Most reactions are local but anaphylaxis and serum sickness are possible | |||
==Bees== | ==Bees (Apids)== | ||
*Barbed Stingers - remain in victims | *Include Bumblebees and Honeybees | ||
*Barbed Stingers - remain in victims and the process of stinging kills the bee | |||
*Killer bees have small individual toxin potency but attack in large numbers | *Killer bees (hybridized African Bees) have small individual toxin potency but attack in large numbers with increased aggression<ref>Díaz-Sánchez C. et al. Suvival after massive (>2000) Africanized Honey bee stings. Arch Intern Med. 1998;158(8):925-927</ref> | ||
* | *Main allergen is phospholipase A2, hyaluronidase and melittin<ref name="King"></ref> | ||
*redness and irritation last 1-3 days | *redness and irritation last 1-3 days | ||
==Wasps== | ==Wasps (Vespids)== | ||
*Non barbed stinger - can sting multiple times | *Include Yellow Jackets, Hornets, and Wasps | ||
*Histamine and bradykinin similar to bees | *Non barbed stinger - can sting multiple times and the sting does not cause the wasps' death | ||
*Histamine, phospholipase, antigen 5, and bradykinin similar to bees<ref name="King"></ref> | |||
*redness and irritation last 1-3 days | *redness and irritation last 1-3 days | ||
==Fire Ants== | ==Fire Ants (Formicidae)== | ||
* | *Alkaloid venom | ||
*Intense burning papules that may turn to pustules in 24hrs | *Intense burning papules that may turn to pustules in 24hrs | ||
*Localized necrosis has also been reported<ref>Fernández-Meléndez S. et al. Anaphylaxis caused by imported red fire ant stings in Málaga, Spain. J Investig Allergol Immunol. 2007;17(1):48-49</ref> | |||
==Treatment== | ==Treatment== | ||
*Immediate treatment for [[Anaphylaxis]] or [[Allergic Reaction]] | |||
*Local wound care and tetanus prophylaxis | *Local wound care and tetanus prophylaxis | ||
*Remove stingers to reduce venom exposure | *Remove stingers to reduce venom exposure | ||
*Oral | *Oral [[Antihistamines]] provide symptoms relief for pruritus | ||
*EpiPen | *EpiPen should be prescribed on discharge | ||
==Review Questions== | ==Review Questions== | ||
Revision as of 00:56, 5 May 2014
Class Hymenoptera
- Subgroups
- Bees
- Wasps
- Ants
- All Hymenoptera share similar components in their venonm and patients can have allergies across the subgroups[1]
- Most reactions are local but anaphylaxis and serum sickness are possible
Bees (Apids)
- Include Bumblebees and Honeybees
- Barbed Stingers - remain in victims and the process of stinging kills the bee
- Killer bees (hybridized African Bees) have small individual toxin potency but attack in large numbers with increased aggression[2]
- Main allergen is phospholipase A2, hyaluronidase and melittin[1]
- redness and irritation last 1-3 days
Wasps (Vespids)
- Include Yellow Jackets, Hornets, and Wasps
- Non barbed stinger - can sting multiple times and the sting does not cause the wasps' death
- Histamine, phospholipase, antigen 5, and bradykinin similar to bees[1]
- redness and irritation last 1-3 days
Fire Ants (Formicidae)
- Alkaloid venom
- Intense burning papules that may turn to pustules in 24hrs
- Localized necrosis has also been reported[3]
Treatment
- Immediate treatment for Anaphylaxis or Allergic Reaction
- Local wound care and tetanus prophylaxis
- Remove stingers to reduce venom exposure
- Oral Antihistamines provide symptoms relief for pruritus
- EpiPen should be prescribed on discharge
Review Questions
- ↑ 1.0 1.1 1.2 King TP et al. Structure and biology of stinging insect venom allergens. Int Arch Allergy Immunol. 2000;123(2):99-106
- ↑ Díaz-Sánchez C. et al. Suvival after massive (>2000) Africanized Honey bee stings. Arch Intern Med. 1998;158(8):925-927
- ↑ Fernández-Meléndez S. et al. Anaphylaxis caused by imported red fire ant stings in Málaga, Spain. J Investig Allergol Immunol. 2007;17(1):48-49