Insect-Sting Anaphylaxis

The European and American approaches to the diagnosis and treatment of insect-sting allergy differ, although there is consensus that venom immunotherapy is the treatment of choice for reducing the risk for future sting reactions. The role of challenge stings in selecting patients for prophylactic treatment is discussed.

Death from allergic reactions to venoms from stinging insects (bees, hornets, yellowjackets, wasps, and fire ants) has been known since antiquity[1]. At least 40 fatalities from stings are reported each year in the United States. Those who are susceptible have been sensitized against specific venom antigens injected by a previous sting. Although not all those who demonstrate immunoglobulin E (IgE) antibody against venom have had a previous reaction[2], studies have shown that 40% to 74% of adults who have had at …