Hymenoptera stings
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 symptom relief for pruritus
- EpiPen should be prescribed on discharge
Review Questions
References
- ↑ 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