mild allergic reaction to bee sting treatment

Late-onset allergic reactions, including serum sick. Acute renal failure following multiple hornet stings. Sakhuja V, Bhalla A, Pereira BJG, Kapoor MM, Bhusnurmath SR, Chugh KS. Postscript to bee stings: delayed “serum sickness.” Hosp Pract 1983 18:36.

The articles I could find were for the late 1980's and may provide some guidance for the treatment of your patient. There is not a lot of data on 'delayed reactions' from sting reactions. There is evidence that VIT improves the quality of the patient’s life in patients with cutaneous systemic reactions.' VIT is still an acceptable option if there are special circumstances, such as frequent exposure, or lifestyle considerations (potential impairment in quality of life) and must be weighed against added cost and potential inconvenience. Prospective sting challenge studies in adults found a less than 3% chance of a more severe reaction in such people. In a prospective field-sting study of children, there was a 10% chance of having a systemic reaction if re-stung (usually milder than their previous sting reactions), and a 3% or less chance of a more severe reaction.

The decision to give VIT for patients with large local reactions must be weighed against the added cost and potential inconvenience.' In patients with more local symptoms then 'However, immunotherapy is usually not required for patients who have experienced only cutaneous systemic reactions after an insect sting. There is, however, increasing evidence that VIT significantly reduces the size and duration of large local reactions and thus might be useful in affected individuals with a history of frequent un- avoidable large local reactions and detectable venom specific IgE. 'Most patients with large local reactions need only symptomatic care and are not candidates for testing for venom specific IgE or venom immunotherapy (VIT). The recent update on Stinging Insect Hypersensitivity addresses immediate dermal reactions to stings and suggests that large local reactions to a sting can be monitored clinically.

Mild allergic reaction to bee sting treatment