INSECT ALLERGIES
Although insect bites are very common, serious reactions usually occur due to bee stings. Anaphylaxis may develop as a result of bee stings.
Reactions due to bee stings can occur at any age. In our country, the most frequent reactions are caused by honey bee ( Apis mellifera ) and wasp ( Vespula vulgaris ) sting. The honey bee leaves the body after inserting the needle, which causes the death of the bee. Bumblebees are very aggressive, with a small stimulus, even if they are not aroused. Since they do not leave their needles with a few hooks, they can insert them many times. Wasp causes more allergic reactions.
Symptoms and Signs of Insect Allergies
Pain, swelling and redness usually occur where insects sting. This is a normal reaction. It usually resolves within a few hours. The risk of developing an allergic reaction is low, but not zero.
Allergic reactions develop in two ways;
Wide Local Reactions
Systemic Reactions
Extensive local reactions begin mildly. However, within 12-24 hours, edema, redness and temperature increase, usually exceeding 20 cm and sometimes involving the whole arm or leg, may occur. Extensive local reactions are reduced after 5-10 days. These reactions are more common in bee growers.
Systemic severe allergic reactions may occur due to bee stings. Since systemic reaction is anaphylaxis, findings related to many organs are seen.
Urticaria (hives), itching and redness.
Edema in face, tongue and throat
Difficulty breathing
Dizziness
Abdominal pain in the style of cramping
Nausea, vomiting and diarrhea
Anaphylaxis due to insect sting is more common in adults than in children. Toxic reactions occur at the same time as a result of stings from a large number of bees. They are reactions that start in a few hours and last for days. Reactions such as life-threatening renal failure, rhabdomyolysis, hemolysis and acute respiratory distress syndrome or diffuse intravascular coagulation syndrome may develop.
Rarely, the mechanism of bee stings is not known, but serum disease-like reactions, encephalitis, peripheral and cranial neuropathies, glomerulonephritis, myocarditis and Guillain-Bare Syndrome may develop in the late period.
The severity of the reactions seen in the previous bites helps predict the severity of the reactions that may occur in subsequent bites. Although the likelihood of developing a systemic reaction decreases with time between bites, the risk never disappears.
Diagnosis of Insect Allergies
Diagnosis is mainly based on clinical history. The nature, timing, reaction time, clinical symptoms and treatment of past insect stings should be reviewed in detail. It is important to determine the genus of the insect.
Venom-specific IgE antibodies can be detected in 20% of healthy adults. Therefore, testing is not recommended for people without complaints.
The skin test result is positive in most patients with a reliable clinical history. Skin test results may be negative in some patients within days or weeks of insect bites. For this, skin tests should be repeated after 4-6 weeks. Skin tests should be carried out by anaphylaxis and performed by specialists.
There is no correlation between sensitivity of skin test and severity of clinical findings. In other words, it should be kept in mind that there may be fatal anaphylactic reactions in people with poor skin test responses.
Venom-specific IgE can be determined in serum for diagnosis. It may be useful in cases where skin tests cannot be performed (use of antihistaminic drugs, presence of severe skin lesions, risk of severe systemic reactions, etc.).
Insect Allergy Treatment and Prevention
Non-reaction bee stings often do not require treatment. Cold compresses or analgesics can be used to reduce pain and swelling.
In the treatment of large local reactions, the application of cold compresses is generally useful in preventing the expansion of the reaction. Antihistamines and topical steroids reduce pain and pruritus. Oral corticosteroids can be used especially for the treatment of large local reactions in the head and neck.
Urgent intervention is required in the treatment of systemic reactions. Adrenaline is the first drug of choice. It can be repeated every 5-15 minutes according to the clinical response. Early diagnosis and appropriate treatment is the most important principle.
Resistance to adrenaline may be seen in patients taking beta-blockers (blood pressure medication).
In some patients, anaphylaxis may be prolonged or may recur within 6-24 hours. Therefore, patients with anaphylaxis should be kept under observation after recovery.
Patients with systemic reactions after bee stings should be referred to allergy and immunology specialists.
Insect Allergy Prevention
Some precautions can protect you from bee stings.
If you don't disturb the bees, they won't let you in. They should be avoided.
Don't panic when the bee stings you. Get out of there slowly. This can protect you from the attack of other bees.
Avoid wearing brightly colored clothing and perfumes.
Be careful when picnicking. Save your food against bees.
Do not walk around your garden barefoot.
Don't forget that bees from large dresses will enter and panic you.
If you have had anaphylaxis, you should always have an adrenaline auto-injector. You must be aware of its use. This could save your life.
Insect Allergies Immunotherapy
Immunotherapy (vaccine) should be performed in patients with anaphylaxis due to bee sting. When properly done, the protection rate is quite high.
47AXX
Chigarid External Analgesic - 0.5 oz, Pack of 2