Haas H, Tran A
Urgences pédiatriques, hôpitaux pédiatriques de Nice, CHU-Lenval, 57, avenue de la Californie, 06200 Nice, France.
Arch Pediatr. 2014 Aug;21(8):913-7. doi: 10.1016/j.arcped.2014.05.002. Epub 2014 Jun 18.
Althought serious illnesses can be transmitted by mosquitoes, the most frequent manifestations are due to the contact with saliva of mosquitoes during the blood meal. Culex and Aedes are meeting in countries with moderate climates. Clinical signs vary according to the immunoallergical response, from simple pruritic wheals to immediate and/or delayed allergic reactions. Some reactions can provoke confusion with an infectious cellulitis and an inappropriate antibiotherapy. The natural history of insect bite reactions in an individual tends to progress through 5 stages until immunizing tolerance settles down. Skin prick testing or Serum specific IgE of whole body extracts are lacking sensibility and specificity. Actually, they must be reserved for the most invalidating or severe cases. The recombinant allergens of the saliva of mosquitoes should allow to improve diagnosis and to envisage immunotherapy.
虽然严重疾病可通过蚊子传播,但最常见的表现是在蚊虫叮咬吸血时接触其唾液所致。库蚊和伊蚊在气候温和的国家出现。临床症状因免疫过敏反应而异,从单纯的瘙痒性风团到即刻和/或延迟性过敏反应。有些反应可能会与感染性蜂窝织炎混淆,导致不适当的抗生素治疗。个体昆虫叮咬反应的自然病程往往会经历5个阶段,直至免疫耐受形成。皮肤点刺试验或全身提取物的血清特异性IgE缺乏敏感性和特异性。实际上,它们只适用于最严重或最无效的病例。蚊子唾液的重组变应原应有助于改善诊断并考虑免疫治疗。