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MeSH Review

Insect Bites and Stings

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Disease relevance of Insect Bites and Stings

  • Measurement of IgE antibodies in postmortem sera may not only provide confirmatory evidence of fatal anaphylaxis following witnessed insect stings, but also may provide useful additional data in unwitnessed deaths where the clinical history or autopsy findings suggest unexplained anaphylaxis [1].
  • Histamine is the main mediator for itch in insect bite reactions and in most forms of urticaria, and in these circumstances the itch responds well to H(1)-antihistamines [2].
  • BACKGROUND: Topical steroids became available, without prescription, in the U.K. in 1987, with hydrocortisone 1% cream first being licensed for irritant contact dermatitis and reactions to insect bites [3].
  • Less frequent causes were insect stings, incompatible blood transfusion, intake of anti-leprosy drug--dapsone in non-G-6PD-deficient patients, and mercuric chloride toxicity in two patients each; naphthalene poisoning in one; and uncertain causes in six patients [4].
  • We report the case of a 57-year-old man with an 8-month history of a progressively enlarging, asymptomatic red patch over the left periorbital region of the face, previously diagnosed as angiolupoid leishmaniasis, insect-bites, 'cellulitis' and treated with several topical antibiotic and steroid therapy, without any improvement [5].

High impact information on Insect Bites and Stings

  • 2 million, from radiocontrast media is 22 000 to 100 000, from latex is 220, and from insect stings is 1.36 million to 13.6 million [6].
  • Loveless on wasp venom allergy and immunity. Part 2. The contribution of Dr Mary Hewitt Loveless to the management of allergy to insect stings [7].
  • A suspect allergen was identified in 68% of the cohort, most frequently a food, medication, or insect sting [8].
  • Histamine-releasing serum factors as a predictor of the outcome of insect sting reactions. Results from a multicentre study [9].
  • The purpose of this study was to extend previous findings of elevated antivenom IgE antibodies in sera from persons experiencing fatal insect sting reactions [1].

Chemical compound and disease context of Insect Bites and Stings


Biological context of Insect Bites and Stings


Anatomical context of Insect Bites and Stings

  • Mode and route of infection, such as skin versus nasal mucosa, insect bites, sexual and gastroenteral transmission, together with genetic factors that may contribute to the outcome of the infection, including HLA, Lewis factor, Nramp1 and more subtle inherited alterations, are discussed [17].

Gene context of Insect Bites and Stings

  • There were no differences between cases and controls for other symptoms, personal or family history of atopy, ingestion of the foods listed, insect sting, or other medications [18].
  • No test was useful immediately after the insect sting, the "anergic period". In agreement with earlier findings, the SPT was the only allergy test that showed statistically significant differences between patients with local and systemic reactions, although a great overlap was found [19].
  • Antivenom is the principal therapy for the majority of medically significant envenomings and is currently supplied through a single source, CSL, Melbourne. Cases of envenoming reported to Australian poisons information centers (PICs) are dominated by spiderbite and insect stings, respectively accounting for 53.7% and 39.3% of all bite/sting calls [20].
  • Lecture on insect stings at Queen of the Valley Hospital in Napa, California [21].
  • Immunotherapy plays an important role in the treatment of allergic rhinitis, asthma, and insect sting allergy [22].

Analytical, diagnostic and therapeutic context of Insect Bites and Stings


  1. Studies in stinging insect hypersensitivity: postmortem demonstration of antivenom IgE antibody in possible sting-related sudden death. Schwartz, H.J., Squillace, D.L., Sher, T.H., Teigland, J.D., Yunginger, J.W. Am. J. Clin. Pathol. (1986) [Pubmed]
  2. Itch: scratching more than the surface. Twycross, R., Greaves, M.W., Handwerker, H., Jones, E.A., Libretto, S.E., Szepietowski, J.C., Zylicz, Z. QJM : monthly journal of the Association of Physicians. (2003) [Pubmed]
  3. Use of nonprescription topical steroids: patients' experiences. Rogers, P.J., Wood, S.M., Garrett, E.L., Krykant, S.P., Haddington, N.J., Hayhurst, J., Player, G.R. Br. J. Dermatol. (2005) [Pubmed]
  4. Acute renal failure due to intravascular hemolysis in the North Indian patients. Chugh, K.S., Singhal, P.C., Sharma, B.K., Mahakur, A.C., Pal, Y., Datta, B.N., Das, K.C. Am. J. Med. Sci. (1977) [Pubmed]
  5. Cutaneous angiosarcoma of the face. Cannavò, S.P., Lentini, M., Magliolo, E., Guarneri, C. Journal of the European Academy of Dermatology and Venereology : JEADV. (2003) [Pubmed]
  6. Anaphylaxis in the United States: an investigation into its epidemiology. Neugut, A.I., Ghatak, A.T., Miller, R.L. Arch. Intern. Med. (2001) [Pubmed]
  7. Loveless on wasp venom allergy and immunity. Part 2. The contribution of Dr Mary Hewitt Loveless to the management of allergy to insect stings. Valentine, M.D. J. Allergy Clin. Immunol. (2003) [Pubmed]
  8. Epidemiology of anaphylaxis in Olmsted County: A population-based study. Yocum, M.W., Butterfield, J.H., Klein, J.S., Volcheck, G.W., Schroeder, D.R., Silverstein, M.D. J. Allergy Clin. Immunol. (1999) [Pubmed]
  9. Histamine-releasing serum factors as a predictor of the outcome of insect sting reactions. Results from a multicentre study. Mosbech, H., Stahl Skov, P., Ebbesen, F., Ebbesen, K., Norn, S., Kristensen, K.S. Clin. Exp. Allergy (1993) [Pubmed]
  10. Allergy to insect stings. II. Phospholipase A: the major allergen in honeybee venom. Sobotka, A.K., Franklin, R.M., Adkinson, N.F., Valentine, M., Baer, H., Lichtenstein, L.M. J. Allergy Clin. Immunol. (1976) [Pubmed]
  11. Cimetidine treatment of recalcitrant acute allergic urticaria. Rusli, M. Annals of emergency medicine. (1986) [Pubmed]
  12. Recurrent infection with Chromobacterium violaceum: first case report from South America. Petrillo, V.F., Severo, V., Santos, M.M., Edelweiss, E.L. J. Infect. (1984) [Pubmed]
  13. Characterisation of salivary gland antigens of Triatoma infestans and antigen-specific serum antibody response in mice exposed to bites of T. infestans. Volf, P., Grubhoffer, L., Hosek, P. Vet. Parasitol. (1993) [Pubmed]
  14. Stings and bites. Tips on coexisting comfortably with the insects. Holmes, H.S. Postgraduate medicine. (1990) [Pubmed]
  15. Allergic responses to airborne allergens and insect venoms. Lichtenstein, L.M. Fed. Proc. (1977) [Pubmed]
  16. ABC of dermatology. Insect bites and infestations. Buxton, P.K. British medical journal (Clinical research ed.) (1988) [Pubmed]
  17. Factors influencing the development of leprosy: an overview. Naafs, B., Silva, E., Vilani-Moreno, F., Marcos, E.C., Nogueira, M.E., Opromolla, D.V. Int. J. Lepr. Other Mycobact. Dis. (2001) [Pubmed]
  18. Exposures and outcomes of children with urticaria seen in a pediatric practice-based research network: a case-control study. Plumb, J., Norlin, C., Young, P.C. Archives of pediatrics & adolescent medicine. (2001) [Pubmed]
  19. Basophil histamine release in insect venom allergy. Engel, T., Heinig, J.H., Weeke, E.R., Schwartz, B., Ingemann, L. Allergy (1988) [Pubmed]
  20. Envenoming and antivenom use in Australia. White, J. Toxicon (1998) [Pubmed]
  21. Lecture on insect stings at Queen of the Valley Hospital in Napa, California. Simon, J.S. The Journal of emergency medicine. (2000) [Pubmed]
  22. Immunotherapy in atopic disorders. Ramirez, D.A., Evans, R. Prim. Care (1979) [Pubmed]
  23. Anaphylactic reactions in children--a questionnaire-based survey in Germany. Mehl, A., Wahn, U., Niggemann, B. Allergy (2005) [Pubmed]
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