Hymenoptera stings

Class Hymenoptera

1. Bees
2. Wasps
3. Fire Ants

• most reactions are local but anaphylaxis and serum sickness are possible

Bees

• Barbed Stingers - remain in victims
• Process kills the bee
• Killer bees have small individual toxin potency but attack in large numbers
• Venom contains histamine, bradykinin
• redness and irritation last 1-3 days

Wasps

• Non barbed stinger - can sting multiple times
• Histamine and bradykinin similar to bees
• redness and irritation last 1-3 days

Fire Ants

• alkaloid venom
• Intense burning papules that may turn to pustules in 24hrs

Treatment

• Local wound care and tetanus prophylaxis
• Remove stingers to reduce venom exposure
• Oral antihistamine
• EpiPen

CME

You are seeing a patient who has been stung by a bee. The risk of his developing anaphylaxis depends most upon which of the following?

	the size of the bee
	the size of the bee’s stinger
	the nature of the most severe previous reaction experienced by the patient
	the amount of cutaneous erythema
	whether the patient is on oral steroid treatment