A critical evaluation of insect sting allergy studies.
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Review was made of the symptoms, treatment and outcome of 151 cases of severe envenomation by the scorpion Centruroides sculpturatus treated with antivenom, 1988-1989. The most frequent symptoms were restlessness, nystagmus, paresthesiae, hypersalivation, fasciculation, blurred vision and dysphagia with an average of four symptoms. Medications before antivenom, given to about half of the subjects, included antihistamines, sedatives, analgesics and epinephrine. In 71% of patients, symptoms were relieved within 30 minutes of receiving one vial. Immediate hypersensitivity reactions occurred in 8%, but were generally mild. Skin tests had a sensitivity of 96% and specificity of 68%. Delayed reactions were not addressed. In conclusion, the antivenom appears safe and effective.
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The sea anemone Anemonia sulcata is the clinically most important Actinaria in the Adriatic Sea. Between 1965 and 1980, 55 patients stung by this cnidarian were seen at the Pula Medical Center in Istria, Yugoslavia. The majority of injuries were inflicted upon the upper extremities, chest, or abdomen. Pain and the appearance of small blanched papules surrounded by slightly reddened and edematous bases were the usually initiating manifestations. Linear lesions were sometimes seen. Vesicles, sometimes filled with serous fluid, localized discoloration, and the formation of bullae sometimes followed. Somnolence, dizziness, nausea, vomiting, muscle aches, and lid edema were reported in some cases. The treatment of these injuries in the northern Adriatic Sea and elsewhere is discussed.