Allergy to bee and wasp stings in children: state of the art

Abstract

Hymenoptera stings are the second most common cause of anaphylaxis in children after food allergies. Identifying the culprit insect is often challenging. Venom-induced anaphylaxis occurs rapidly, within minutes of stinging, and involves multiple organ systems. Diagnosis is based on clinical history and confirmation of IgE-mediated sensitization. Basal serum tryptase levels should also be determined in patients with anaphylaxis after stinging, as elevated levels are associated with a greater risk of severe reactions.

The cornerstone of acute management of venom-induced anaphylaxis is intramuscular injection of adrenaline. Prevention of future systemic reactions includes venom immunotherapy and preventive measures to avoid accidental contact with hymenoptera.