Honeybee Stings in the Era of “Killer Bees”: Anaphylaxis and Toxic Envenomation

Twenty-six years after the arrival of “killer bees” in Arizona, the entire state with the exception of high elevations in the north is populated with this bee variety and 11 people have died at the scene of massive bee attacks.
Source: The American Journal of Medicine - Category: General Medicine Authors: Source Type: research

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Authors: Abstract The increasing number of patients with anaphylactic reactions is a modern challenge for healthcare professionals in clinical practice and public health professionals. It remains difficult to determine the prevalence or incidence of anaphylaxis in the population due to the long absence of a consensus definition, the fact that analyses are performed on various population groups and the use of different data collection methodologies. In the United States, anaphylaxis mortality ranges from 0.63 to 0.76 cases per million inhabitants, with 58% of these deaths due to drug anaphylaxis. The risk factors f...
Source: Neuroendocrinology Letters - Category: Endocrinology Tags: Neuro Endocrinol Lett Source Type: research
Hymenoptera venom allergy is one of the most frequent causes of anaphylaxis. In its most severe form, the reaction to wasp and honey bee stings may be life-threatening. Therefore, immediate and proper diagnosis o...
Source: Allergy, Asthma and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Research Source Type: research
This article reviews the definition, classification, evaluation, differential diagnosis, prognosis, complications, and management of anaphylaxis. Tailored for internists, the article focuses on anaphylactic medication allergies. It provides a guide to optimally evaluate and manage patients with antibiotic allergy using a simple, rapid risk stratification technique, graded antibiotic challenge (test dose), and/or allergist-guided drug desensitization. It also reviews other causes of anaphylaxis that internists are likely to encounter, and an approach to their management. PMID: 31757236 [PubMed - in process]
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Med Clin North Am Source Type: research
Abstract Stinging insect allergy is uncommon but can be life threatening. Diagnosis requires clinical history and confirmative skin or blood testing by an allergist. Baseline serum tryptase level can be used to stratify risk. Treatment is supportive for all reactions except for anaphylaxis, which is treated with intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids, and oxygen. Venom immunotherapy is most effective for long-term management in patients with a history of anaphylaxis. Venom immunotherapy rapidly reduces the risk of sting anaphylaxis by up to 98% and maintenance treatmen...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Med Clin North Am Source Type: research
For this month ’s Annals the three recent reviews for ‘From pages of Allergy Watch’ focused on articles about anaphylaxis. The first article reviews a prospective cohort study evaluating potential predictors of severe reactions after Hymenoptera stings. The next article cites data from a large US claims data base to predict patients at risk for recurrent ED visits for anaphylaxis. The last review analyzed data from the European Anaphylaxis Registry finding that only 27% of patients received epinephrine as first line treatment.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Special Series Source Type: research
This article reviews the definition, classification, evaluation, differential diagnosis, prognosis, complications, and management of anaphylaxis. Tailored for internists, the article focuses on anaphylactic medication allergies. It provides a guide to optimally evaluate and manage patients with antibiotic allergy using a simple, rapid risk stratification technique, graded antibiotic challenge (test dose), and/or allergist-guided drug desensitization. It also reviews other causes of anaphylaxis that internists are likely to encounter, and an approach to their management.
Source: Medical Clinics of North America - Category: Primary Care Authors: Source Type: research
Questions and controversies regarding venom immunotherapy (VIT) remain. It is important to recognize risk factors for severe sting anaphylaxis that guide the recommendation for testing, epinephrine injectors, and VIT. Premedication, rush VIT, and omalizumab are successful in overcoming recurrent systemic reactions to VIT. A maintenance dose is adequate in children, but higher doses are needed in high-risk patients. The consensus on risk of β-blockers and angiotensin-converting enzyme inhibitors in patients on VIT has shifted to the belief that risk is small. The decision to stop VIT after 5 years rests on known r...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
Hymenoptera venom allergy is commonly an immediate (type I) hypersensitivity reaction. There are only a handful of reported cases of delayed IgE-mediated reactions to these relatively common allergens.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
Systemic mastocytosis (SM) is an accumulation of mast cells in tissue. Patients with SM may have clinical manifestations involving cutaneous, gastrointestinal, musculoskeletal, cardiovascular, neurological systems. Patients are also more likely to have anaphylaxis following a Hymenoptera sting. Current treatment for SM includes antihistamines, antileukotriene agents, Oral cromolyn. Imatinib may be used in patients without D816V mutation. Omalizumab is not currently approved for use in SM.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
Stinging insect allergy is uncommon but can be life threatening. Diagnosis requires clinical history and confirmative skin or blood testing by an allergist. Baseline serum tryptase level can be used to stratify risk. Treatment is supportive for all reactions except for anaphylaxis, which is treated with intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids, and oxygen. Venom immunotherapy is most effective for long-term management in patients with a history of anaphylaxis. Venom immunotherapy rapidly reduces the risk of sting anaphylaxis by up to 98% and maintenance treatment can be stopped a...
Source: Medical Clinics of North America - Category: Primary Care Authors: Source Type: research
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