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At least 343 records · Page 19Linked to original sources
PubMed1983

Anaphylaxis after Hymenoptera stings in three patients with urticaria pigmentosa.

Three patients with urticaria pigmentosa are reported who developed symptoms of anaphylaxis after Hymenoptera stings. Serum IgE antibodies to various Hymenoptera venoms could not be detected in any of the patients. Skin tests were completely negative in one patient, and borderline reactions with honeybee and yellow jacket venom, respectively, were found in the other two. Peripheral blood leukocytes of these latter two patients did not release significant amounts of histamine after exposure to the respective venoms. In patients with mastocytosis, anaphylaxis after insect stings may not be IgE-mediated but due to mediator release by the pharmacologic action of histamine liberators normally present in Hymenoptera venoms.

Adult↗
PubMed1985

Stinging insect allergy: natural history and modification with venom immunotherapy.

The natural history of stinging insect allergy and its modification by venom immunotherapy was investigated by follow-up observations of patients with histories of venom anaphylaxis and detectable venom-specific IgE. The patients were divided into three categories: (1) receiving venom immunotherapy, (2) declined venom immunotherapy, and (3) terminated venom immunotherapy. One hundred twenty-seven patients were evaluated after 6 mo to 9 yr of venom immunotherapy. Most received top venom doses of 50 micrograms of yellow jacket and/or honeybee venoms every 4 wk. There were 87 restings in 48 patients resulting in two systemic reactions, only one of which could be considered a treatment failure (1%). Fifty-six patients never received venom immunotherapy. In this group there were 40 restings in 28 patients with 14 systemic reactions (35%). In 88 patients who stopped venom immunotherapy, 61 restings in 41 patients led to 11 systemic reactions (17%). Patients with cardiovascular/or respiratory symptoms with initial sting anaphylaxis were at risk for subsequent reactions. With one exception, patients with hives and edema only as the initial reaction either had a similar or no reaction when they were restung. These results confirm the efficacy of venom immunotherapy but also suggest that there are factors other than the presence of venom-specific IgE modulating the occurrence of clinical anaphylaxis.

Adolescent↗
PubMed1989

Survey of fatal anaphylactic reactions to imported fire ant stings. Report of the Fire Ant Subcommittee of the American Academy of Allergy and Immunology.

A physician questionnaire survey was conducted by the Fire Ant Subcommittee of the American Academy of Allergy and Immunology to document deaths caused by imported fire ant stings. From the 29,300 physicians surveyed, reports of 83 fatal and two near-fatal fire ant-sting reactions were received. Most anaphylactic deaths were reported from Florida (22) and Texas (19). After excluding duplicate reports, four confirmed deaths were documented in Alabama, 10 in Florida, two in Georgia, two in Louisiana, and 14 in Texas.

Adult↗
PubMed1989

Survey of whole body-extract immunotherapy for imported fire ant- and other hymenoptera-sting allergy. Report of the Fire Ant Subcommittee of the American Academy of Allergy and Immunology.

A survey of 5300 allergists was conducted to determine the number and geographic distribution of patients receiving immunotherapy for imported fire ant (IFA) allergy in the United States and Canada. Responses were received from 1293 physicians who reported a total of 2573 patients being treated in 28 states. Most patients were from the southeast, but some patients were reported to be receiving IFA immunotherapy in areas outside the boundaries of known IFA infestation. Although IFA is a widespread health hazard in the southeast, it appears to exert an uneven impact on allergy practice in this region. Of the 1293 physicians responding to the survey, 117 (9%) reported the use of whole body extract (WBE) in the treatment of 1746 patients with winged Hymenoptera-sting allergy. Continued use of WBE immunotherapy was reported by physicians from all regions of the United States and from Canada. The largest numbers of patients receiving winged WBE immunotherapy were reported from Texas (641), Pennsylvania (246), Florida (129), and Canada (127). The results of this survey suggest a need for continuing medical education regarding (1) the magnitude of the health hazard posed by the IFA and (2) the efficacy of venom versus WBE in the treatment of winged Hymenoptera-sting allergy.

Animals↗
PubMedDate not supplied

Management of hymenoptera sting anaphylaxis: a preventive medicine survey.

The evaluation of aftercare instructions given to patients suffering from hymenoptera sting anaphylaxis was the objective of the study. Part of this evaluation included asking the physicians questions to examine the knowledge on which they based their aftercare instructions. Survey questionnaires were completed by 124 of 174 (71%) physicians who worked in an emergency department or urgent care center. Fifty-eight percent of the physicians never provided written avoidance instructions, 24% provided or prescribed anaphylaxis ID bracelets, 44% referred all of their patients to an allergist for further evaluation, and 73% reported prescribing an Epi-pen or Ana-kit to all hymenoptera sting anaphylaxis victims. Twenty-four percent of physicians did not know where to obtain anaphylaxis identification bracelets. This survey demonstrates that a substantial number of physicians practicing emergency medicine are not providing appropriate aftercare instructions to patients, and substantiates the need for educational efforts to increase the awareness of physicians concerning the implications of hymenoptera allergy and the value of proper preventive measures.

Anaphylaxis↗
PubMedDate not supplied

Myeloradiculopathy associated with wasp sting.

A 12-year-old girl developed a reversible myeloradiculopathy 1 week after a wasp sting. Delayed neurologic hypersensitivity reactions to Hymenopteran stings occur primarily in adults. Reactions involving both the peripheral and central nervous systems are extremely rare and have never been reported in a child. The mechanisms underlying this uncommon reaction may be related to age-dependent differences in immunologic responses.

Animals↗
PubMed2005

Infective endocarditis associated with a scorpion sting.

We report the successful surgical intervention in two cases of aortic valve bacterial endocarditis after scorpion stings. Infective endocarditis developed in both patients several weeks after they suffered repeated scorpion stings. Both patients had similar, but uncommon features: (1) the isolated organisms were unusual causes of infective endocarditis (streptococcus group G and Streptococcus milleri), (2) annular abscesses developed that required either aortic root replacement with a homograft or annular patch repair with pericardium, and (3) complete heart block developed postoperatively, requiring permanent pacemaker implantation. Both patients completed a 6-week postoperative course of antibiotic therapy and are without recurrent infection.

Adult↗
PubMed2006

Kounis syndrome associated with hypersensitivity to hymenoptera stings.

Hymenoptera stings can induce acute coronary syndromes by different pathogenetic mechanisms including direct action of the venom constituents on the coronary endothelium or allergic reaction with mediators acting on the coronary vasculature. Two patients were stung by wasps and honeybees and developed Kounis syndrome as a consequence of allergic reaction. Kounis syndrome is the concurrence of acute coronary syndromes with mast cell activation induced by allergic or hypersensitivity and anaphylactic of anaphylactoid reactions. It is caused via inflammatory mediators released through mast cell activation. The patients had pre-existing coronary artery disease (type II variant of Kounis syndrome) and the allergic reaction induced by hymenoptera stings seems to have triggered inflammatory mediator release. The pathophysiology and clinical implications of this association are discussed.

Aged↗
PubMed1980

Diagnosis and treatment of anaphylactic reactions to Hymenoptera stings in children.

Forty-four children (mean age 9.6 years) with a history of an allergic reaction(s) to an insect sting and with positive insect venom skin tests were studied. IgE antibodies (RAST) to honeybee phospholipase A and to yellow jacket venom were found in the sera of 78% and 77%, respectively, of these patients. The patients were immunized with the appropriate venoms over a 15-week course and most were then subjected to an in-hospital sting; there was a 3% reaction rate (1/37). Clinical protection as associated with a fivefold increase in anti-venom IgG. Five patients did not develop a significant increase in IgG antibody and they were treated more vigorously; four were stung subsequently without reaction. Two patients did not react when stung in the field; positive identification of the culprit insect was obtained. Twenty patients were re-stung after one year of maintenance therapy; there was a single mild, delayed reaction. Immunotherapy also increased the IgE antibody against venom 3.7-fold at three months; after one year of therapy the IgE antibody level had decreased but was still 40% greater than at the outset. Immunotherapy was associated with a 25% incidence of local pain and swelling and a 6% incidence of systemic reactions. We conclude that venom therapy in children is safe and effective. The indications for initiating immunotherapy require further definition.

Adolescent↗
PubMed1984

A prospective study of the natural history of large local reactions after Hymenoptera stings in children.

Large local reactions are a frequent occurrence after insect stings. We prospectively studied the demography, immunology, and significance of these reactions in the pediatric age group. Most children (83%) who have had large local reactions have positive skin test results to one or more venoms. Elevated amounts of venom-specific IgE antibody are usually present. Over 3 to 5 years, allergic sensitivity declines, as evidenced by less positive skin test results and lower levels of antivenom IgE antibodies. Most significantly, of 113 repeat stings, only 2% resulted in a systemic reaction.

Adolescent↗
PubMed2001

Clinical symptoms observed in children envenomated by scorpion stings, at the children's hospital from the State of Morelos, Mexico.

Scorpion sting is a public health problem in Mexico (Toxicon, 32 (1994) 1015). Since the most severe cases occur in children, cases treated at the Hospital del Niño Morelense, Cuernavaca, during the entire year of 1997 were registered and studied. During this 12-month period, 163 cases required medical attention, with the following results: 45% were mild, 25% moderate and 30% were severe cases of envenoming. Thanks to anti-venom therapy none of the children died. The most frequently observed clinical symptoms were: local pain and redness, salivation, dysphagia, tachycardia, irritability, odynophagia, paresthesia, nasal pruritus and emesis. The mild cases had one or two symptoms, moderate envenoming was characterized by several of the symptoms, whereas severe cases had most of the clinical symptoms listed. The moderate and severe cases were all treated with horse F(ab)2-anti-venom, while the mild cases were kept only for observation. Male children constituted 63% of the cases. The mean time that elapsed between sting and first medical attention was 54min.

Animals↗
PubMed2001

Corneal bee sting with retained stinger.

Bee stings of the cornea are rarely reported, but have the potential for causing serious ophthalmologic injuries. We present a case of corneal bee sting with retained stinger apparatus and associated iritis and discuss the pathologic mechanisms of injury, evaluation, and treatment of these uncommon presentations.

Adult↗
PubMed2006

Insect sting allergy and venom immunotherapy.

OBJECTIVE: To review specific aspects of venom immunotherapy (VIT) in the context of allergen immunotherapy (AIT) in general. DATA SOURCES: Immunotherapy Collegium II presented at the 2005 Annual Meeting of the American College of Allergy, Asthma and Immunology. STUDY SELECTION: Discussions of VIT during Immunotherapy Collegium II. RESULTS: The decision to recommend VIT is based on a detailed history and confirmatory diagnostic tests, as well as a knowledge of the natural history of the disease and its impact on quality of life. Skin tests and radioallergosorbent tests are complementary in that neither can detect all cases of insect sting allergy. Unlike inhalant AIT, rush regimens are as safe as slower regimens for initial VIT, and 4- to 8-week maintenance intervals are typical for VIT. In contrast to inhalant AIT, large local reactions are common and expected with VIT and should not limit the maintenance dose. VIT induces full immune tolerance in 85% of patients after 5 years, whereas this occurs in 30% to 50% of patients with inhalant AIT. VIT is often discontinued after 5 years even though skin test results are usually still positive, but a 10% to 15% chance of reaction persists for many years and is greater in patients who had near-fatal reactions before treatment, those who had systemic reactions during VIT, those with honeybee allergy, and those treated for less than 5 years. Children who receive 3 to 5 years of VIT have a lasting immune tolerance for 10 to 20 years afterward. CONCLUSION: The appropriate use of VIT for prevention of insect sting allergy requires knowledge of the natural history of the disease and would benefit from a better understanding of the mechanisms of successful immunotherapy for the induction of immune tolerance.

Bites and Stings↗
PubMed2005

Respiratory allergy to the indoor ant (Monomorium pharaonis) not related to sting allergy.

BACKGROUND: Many studies are available on systemic reactions to ant sting, but few have described the direct role of ants in respiratory allergy. The nonstinging house ant, Monomorium pharaonis (pharaoh ant), is a highly infesting species in indoor environments. OBJECTIVE: To determine whether the pharaoh ant is an indoor source of aeroallergens. METHODS: Two patients with asthma who lived in homes with ant infestation were enrolled. Pharaoh ants were collected at the patients' homes, and crude extracts were prepared. Skin prick tests with ant extracts were performed. Specific IgE to pharaoh ant was measured by enzyme-linked immunosorbent assay (ELISA), and the allergenic components were determined by using immunoblot analysis. Cross-reactivity among pharaoh ant, imported fire ant, Pachycondyla chinensis ant, and other indoor allergens was evaluated by ELISA inhibition tests. Specific bronchial challenge testing was performed using pharaoh ant extracts. RESULTS: Both patients had positive skin test reactions to pharaoh ant extract and high levels of specific IgE antibodies to pharaoh ant. The ELISA inhibition test results demonstrated significant inhibition by pharaoh ant; however, P. chinensis, cockroach, and house dust mite showed no inhibition of the IgE binding to pharaoh ant. Two important IgE-binding components, 9.4 and 34 kDa, were identified by using immunoblot analysis. Pharaoh ant bronchial challenge test results showed typical early asthmatic reactions in 1 patient and dual asthmatic reactions in the other patient. CONCLUSIONS: Ants can induce IgE-mediated bronchoconstriction regardless of sting in sensitized patients. Ants should be taken into consideration as a cause of respiratory allergy in patients living in homes with visual evidence of infestation.

Air Pollution, Indoor↗
PubMed2003

Discovery of 3-methyl-2-buten-1-yl acetate, a new alarm component in the sting apparatus of Africanized honeybees.

We analyzed the alarm pheromone components from five colonies of Africanized honeybees and three colonies of European honeybees collected in Mexico. Analyses revealed a novel alarm pheromone component that was only present in appreciable quantities in the Africanized bee samples. Analysis of the mass spectrum and subsequent synthesis confirmed that this compound is 3-methyl-2-buten-1-yl acetate (3M2BA), an unsaturated derivative of IPA. In Africanized honeybees, sampling from stings of guards showed that 3M2BA was present at levels of 0-38% the amount of isoamyl acetate (IPA). Behavioral assays from three colonies each of Africanized and European bees showed that 3M2BA recruited worker bees from hives of both Africanized bees and European bees at least as efficiently as isopentyl acetate IPA, a compound widely reported to have the highest activity for releasing alarm and stinging behavior in honeybees. However, a mixture of of 3M2BA and IPA (1:2) recruited bees more efficiently than either of the compounds alone. None of the compounds differed in their efficacy for inducing bees to pursue the observers.

Acetates↗
PubMed1997

Characterization of proliferative responses and cytokine mRNA profiles induced by Vespula venom in patients with severe reactions to wasp stings.

The reasons why severe allergic reactions to bee and wasp stings develop in only a small portion of exposed individuals are incompletely understood, but differences in T cell responses to venom antigens comparing allergic and non-allergic individuals are likely to be important. To identify such differences, venom-induced proliferative responses and cytokine mRNA production by blood mononuclear cells from Vespula venom-allergic patients and non-allergic individuals were compared. Mononuclear cells from most venom-allergic patients proliferated in response to alkylated Vespula venom (7275 +/- 8387 ct/min, n = 19), and the extent of proliferation was greater for patients with a history of multiple prior stings and those with high levels of venom-specific IgE. Although mononuclear cells from non-allergic subjects showed little or no proliferation in response to venom (926 +/- 711 ct/min, n = 8), production of mRNAs coding for IL-2, IL-4, IL-5, IL-10 and interferon-gamma (IFN-gamma) in response to Vespula venom by cells from non-allergic subjects was detected by reverse transcriptase-polymerase chain reaction (RT-PCR), indicating that these individuals had been previously sensitized to venom antigens. In contrast to the Th0 cytokine mRNA profile observed for non-allergic individuals, venom-allergic patients released a more restricted profile of cytokines following stimulation with venom. Only IFN-gamma mRNA expression was detected in all individuals evaluated, whereas IL-2 mRNA was not detected during the first 48 h of stimulation, and T cells from only one of three venom-allergic individuals produced detectable IL-4 or IL-5 mRNA. The difference in cytokine profiles observed comparing venom-allergic patients and non-allergic controls could not be attributed to intrinsic differences in T cells from these individuals, because polyclonal stimulation with phorbol myristate acetate (PMA) + ionophore induced similar cytokine mRNA profiles in the two groups. These studies demonstrate clear differences in the T cell responses of venom-allergic subjects, that may contribute to the development of severe allergic reactions in these individuals.

Adult↗
PubMed1998

A case report of an unusual mandibular swelling in a 4-year-old child possibly caused by a jellyfish sting.

Animal bites and stings may not figure highly in the differential diagnosis of facial swelling in the United Kingdom but should be considered in those who have been in a tropical area. This case report documents details of the presentation and investigation of a case of jellyfish sting that appeared as a facial swelling in a 4-year-old girl who had recently been on holiday in Greece. The report emphasizes the requirement to consider unusual aetiological factors in cases of facial swelling.

Animals↗
PubMed2002

A randomized paired comparison trial of cutaneous treatments for acute jellyfish (Carybdea alata) stings.

The objective of the study was to compare cutaneous treatments (heat, papain and vinegar) for acute jellyfish (Carybdea alata) stings. Healthy adult volunteer subjects received a single-tentacle jellyfish sting on each forearm. One forearm was treated with hot-water immersion (40-41 degrees C). This was compared with the other forearm, which was randomized to a comparison treatment of papain meat tenderizer or vinegar. Pain was measured at 0, 2, 4, 6, 8, 10, 15, and 20 minutes using a 10-cm visual analog scale (VAS). For 25 subject runs, the average VAS scores at t = 0 were 3.6 cm (hot water) and 3.7 cm (comparison treatment). At t = 4 minutes (2 minutes after treatment had started), the differences between hot-water and comparison group VAS scores were 2.1 cm versus 3.2 cm, respectively. The mean difference between hot-water and comparison treatments was 1.1 cm (95% confidence interval, 0.6 to 1.6). At t = 20 minutes (the end of the study period), the differences between hot-water and comparison group VAS scores were 0.2 cm versus 1.8 cm, respectively. The mean difference between hot-water and comparison treatments was 1.6 cm (95% confidence interval, 0.9 to 2.3). This study suggests that the most efficacious initial treatment for C alata jellyfish envenomation is hot-water immersion to the afflicted site.

Acetic Acid↗