Tan John W, Campbell Dianne E
Department of Allergy and Immunology, Children's Hospital Westmead; Discipline of Paediatric and Child Health, University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2013 Sep;49(9):E381-7. doi: 10.1111/jpc.12178. Epub 2013 Apr 16.
Allergic reactions to insect bites and stings are common, and the severity of reactions range from local reaction to anaphylaxis. In children, large local reaction to bites and stings is the most common presentation. Stings from insects of the order Hymenoptera (bees, wasps and ants) are the most common cause of insect anaphylaxis; however, the proportion of insect allergic children who develop anaphylaxis to an insect sting is lower than that of insect allergic adults. History is most important in diagnosing anaphylaxis, as laboratory tests can be unreliable. Venom immunotherapy is effective, where suitable allergen extract is available, but is only warranted in children with systemic reactions to insect venom. Large local reactions are at low risk of progression to anaphylaxis on subsequent stings, and hence, venom immunotherapy is not necessary.
昆虫叮咬和蜇伤引起的过敏反应很常见，反应的严重程度从局部反应到过敏反应不等。在儿童中，叮咬和蜇伤引起的大面积局部反应是最常见的表现。膜翅目昆虫（蜜蜂、黄蜂和蚂蚁）的蜇伤是昆虫过敏反应最常见的原因；然而，对昆虫过敏的儿童发生昆虫蜇伤过敏反应的比例低于对昆虫过敏的成人。病史在诊断过敏反应中最为重要，因为实验室检查可能不可靠。在有合适的过敏原提取物的情况下，毒液免疫疗法是有效的，但仅适用于对昆虫毒液有全身反应的儿童。大面积局部反应在随后的蜇伤中发展为过敏反应的风险较低，因此，不需要进行毒液免疫疗法。
