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HYMENOPTERA STINGS

HYMENOPTERA STINGS is a topic covered in the Harrison's Manual of Medicine.

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Epidemiology: The hymenoptera include bees, wasps, hornets, yellow jackets, and ants. About 100 deaths from hymenoptera stings occur annually in the United States, nearly all due to allergic reactions to venoms. An estimated 0.4–4.0% of the U.S. population exhibits immediate-type hypersensitivity to insect stings.

  • Clinical Features
    • Uncomplicated stings cause pain, a wheal-and-flare reaction, and local edema that subside within hours.
    • Multiple stings (e.g., from wasps, hornets, ants) can lead to vomiting, diarrhea, generalized edema, dyspnea, hypotension, rhabdomyolysis, renal failure, and death.
    • Large (>10-cm) local reactions (e.g., with erythema, edema, warmth, tenderness) progressing over 1–2 days are not uncommon; while they resemble cellulitis, they are in fact hypersensitivity reactions. Such reactions recur on subsequent exposure but are seldom accompanied by anaphylaxis.
    • Serious reactions occur within 10 min (and rarely >5 h) after the sting and include upper airway edema, bronchospasm, hypotension, shock, and death.

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Citation

Loscalzo, Joseph, et al., editors. "HYMENOPTERA STINGS." Harrison's Manual of Medicine, 19th ed., McGraw Hill Inc., 2017. harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623680/all/HYMENOPTERA_STINGS.
HYMENOPTERA STINGS. In: Loscalzo J, Jameson JL, Longo DL, et al, eds. Harrison's Manual of Medicine. 19th ed. McGraw Hill Inc.; 2017. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623680/all/HYMENOPTERA_STINGS. Accessed April 21, 2019.
HYMENOPTERA STINGS. (2017). In Loscalzo, J., Jameson, J. L., Longo, D. L., Hauser, S. L., Fauci, A. S., & Kasper, D. L. (Eds.), Harrison's Manual of Medicine. Available from https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623680/all/HYMENOPTERA_STINGS
HYMENOPTERA STINGS [Internet]. In: Loscalzo J, Jameson JL, Longo DL, Hauser SL, Fauci AS, Kasper DL, editors. Harrison's Manual of Medicine. McGraw Hill Inc.; 2017. [cited 2019 April 21]. Available from: https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623680/all/HYMENOPTERA_STINGS.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - HYMENOPTERA STINGS ID - 623680 ED - Loscalzo,Joseph, ED - Jameson,J Larry, ED - Longo,Dan L, ED - Hauser,Stephen L, ED - Fauci,Anthony S, ED - Kasper,Dennis L, BT - Harrison's Manual of Medicine UR - https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623680/all/HYMENOPTERA_STINGS PB - McGraw Hill Inc. ET - 19 DB - Harrison's Manual of Medicine DP - Unbound Medicine ER -