Insect Stings

To the Editor.— This LETTER presents the current management of insect stings and reflects the views and experience of the Committee on Insects of the American Academy of Allergy. Local reactions to insect stings are manifested by redness, whealing, itching, swelling, or pain at the site. Occasionally, the local swelling is extensive, with much discomfort, distortion of the part involved, fear, and apprehension. These reactions are not necessarily due to an allergic mechanism, but may result from the direct action of chemicals, enzymes, or toxins in the venom. Treatment may include cold compresses or oral administration of antihistamines and analgesics. It has not been clearly demonstrated that large local reactions are forerunners of more serious reactions, and hyposensitization therapy is usually not indicated. The vast majority of systemic reactions and deaths have followed stings from bees, hornets, wasps, and yellow jackets (Hymenoptera), and are believed due to an allergic reaction.