Diaz James H
School of Public Health, Louisiana State University Health Sciences Center, New Orleans 70112, USA.
J La State Med Soc. 2007 May-Jun;159(3):149-57.
Hymenopterid stings and subsequent allergic reactions are a common indication for emergency department visits worldwide. Unrecognized anaphylactic reactions to hymenopterid stings by apids, or bees, and vespids, or wasps, are a significant cause of sudden and unanticipated deaths outdoors in young people, with and without atopic histories. Insect bites and stings, often complicated by allergic reactions or skin infections, by community-acquired pathogens, such as methicillin-resistant Staphylococcus aureus, are common sources of morbidity following hurricanes, tropical storms, and prolonged flooding. This article will review and critically analyze the descriptive epidemiology and outcomes of hymenopterid bites, stings, and allergic reactions, especially following hurricanes and prolonged flooding disasters; stratify the immunologic reactions to hymenopterid stings by clinical severity and outcomes; and present current recommendations for management, prophylaxis, and prevention of hymenopterid stings and reactions.
膜翅目昆虫叮咬及随后的过敏反应是全球急诊就诊的常见原因。对蜜蜂及黄蜂等膜翅目昆虫叮咬未识别出的过敏反应是年轻人在户外突发意外死亡的重要原因，无论有无特应性病史。昆虫叮咬，常因社区获得性病原体（如耐甲氧西林金黄色葡萄球菌）引起的过敏反应或皮肤感染而复杂化，是飓风、热带风暴和长期洪水过后发病的常见原因。本文将回顾并批判性分析膜翅目昆虫叮咬、蜇伤及过敏反应的描述性流行病学和结局，尤其是在飓风和长期洪水灾害之后；按临床严重程度和结局对膜翅目昆虫蜇伤的免疫反应进行分层；并提出当前关于膜翅目昆虫蜇伤及反应的管理、预防和防治建议。
