I was stung and had a reaction! Do I need to see an allergist?
Late summer is the time for yellow jackets, wasps, hornets and honey bees to be active. Most insect stings will cause a local reaction (pain, redness and swelling at the sting site) lasting a day or so. Sometimes, the reaction is more than that and the question arises, do I need to see an allergist?
Here is a simple check list to assist you in making decisions.
When to go to the ER or call 911:
- Feeling of “impending doom,” loss of consciousness, shock (low blood pressure), seizure
- Lower Respiratory: difficulty breathing, wheezing, chest tightness, coughing or shortness of breath
- Upper Respiratory: tongue or throat swelling, difficulty swallowing, talking or breathing
- Skin: persons over 16 years old with generalized hives (welts) or swelling
- GI: cramps, abdominal pain, vomiting, diarrhea
When to see an allergist:
Any person who has experienced one or a combination of the above symptoms should be evaluated by an allergist. The single best predictor of the outcome of a future sting is still the severity of the previous sting reaction.
A person who has experienced recurrent large local reactions (swelling, redness that extends well beyond the sting site), spends considerable amounts of time outdoors where stinging insects are present and has needed recurrent courses of oral steroids (prednisone) for treatment.
Why see an allergist?
Allergy injections to the insect venom (called venom immunotherapy or VIT) are a very effective treatment and can decrease the risk of a future severe allergic reaction to 2% for many patients. If not treated with VIT, up to 75% of patients if re-stung will have a severe reaction. Venom allergy skin testing combined with blood IgE to the specific venom can determine which insect is the problem and help differentiate a toxic reaction or other non-allergic reaction from a true allergic reaction. In addition, a blood test for tryptase will be done. If the tryptase level is elevated, there is an increased risk of severe reaction to an insect sting, increased chance of reaction to VIT, failure of VIT and increased risk of severe reaction after VIT is stopped.
More than 5% of the population has insect sting allergy, yet few patients are referred for diagnostic testing and specific treatment. At Family Allergy & Asthma Care of Montana, we specialize in sorting out the reaction and offer state-of-the-art approaches for diagnosis and treatment of insect sting reactions. Why? We want our patients to BEE healthy and happy!
This information is solely for informational purposes and not intended as a substitute for consultation with a medical professional.