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Wasp Stings Differential Diagnoses

  • Author: Carl A Mealie, MD, FACEP, FAAEM; Chief Editor: Joe Alcock, MD, MS  more...
Updated: Sep 22, 2015
Contributor Information and Disclosures

Carl A Mealie, MD, FACEP, FAAEM Assistant Professor, Department of Emergency Medicine, Hofstra North Shore-LIJ School of Medicine; Chief of Operations, Department of Emergency Medicine, Long Island Jewish Medical Center

Carl A Mealie, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physicians, American Medical Association, New York Academy of Medicine, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.


Max Vernon Wisgerhof, II, MD Fellowship Program Director, Department of Endocrinology and Metabolism, Henry Ford Hospital

Max Vernon Wisgerhof, II, MD is a member of the following medical societies: American Thyroid Association, Endocrine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center

Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Lisa Kirkland, MD, FACP, FCCM, MSHA Assistant Professor, Department of Internal Medicine, Division of Hospital Medicine, Mayo Clinic; Vice Chair, Department of Critical Care, ANW Intensivists, Abbott Northwestern Hospital

Lisa Kirkland, MD, FACP, FCCM, MSHA is a member of the following medical societies: American College of Physicians, Society of Hospital Medicine, Society of Critical Care Medicine

Disclosure: Nothing to disclose.


Alan S Multz, MD Associate Professor of Clinical Medicine, Albert Einstein College of Medicine; Program Director, Internal Medicine Residency, Associate Chairman, Department of Medicine, Long Island Jewish Medical Center

Alan S Multz, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Astellas Pharmaceutical Honoraria Consulting; Merck Pharmaceutical Honoraria Speaking and teaching; The Medicines Company Honoraria Consulting; Schering Plough Honoraria Speaking and teaching; Wyeth Pharmaceuticals Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

  1. Starr CK. A simple pain scale for field comparison of Hymenoptera stings. J Entomol Sci. 1985 April. 20:225-31.

  2. Pumphrey RS, Roberts IS. Postmortem findings after fatal anaphylactic reactions. J Clin Pathol. 2000 Apr. 53(4):273-6. [Medline].

  3. Nittner-Marszalska M, Cichocka-Jarosz E. Insect sting allergy in adults: key messages for clinicians. Pol Arch Med Wewn. 2015 Sep 3. pii: AOP_15_083:[Medline].

  4. Forrester JA, Holstege CP, Forrester JD. Fatalities from venomous and nonvenomous animals in the United States (1999-2007). Wilderness Environ Med. 2012 Jun. 23(2):146-52. [Medline].

  5. Guenova E, Volz T, Eichner M, Hoetzenecker W, et al. Basal serum tryptase as risk assessment for severe Hymenoptera sting reactions in elderly. Allergy. 2010 Jul. 65(7):919-23. [Medline].

  6. Diaz JH. The impact of hurricanes and flooding disasters on hymenopterid-inflicted injuries. Am J Disaster Med. 2007 Sep-Oct. 2(5):257-69. [Medline].

  7. Sun Z, Yang X, Ye H, Zhou G, Jiang H. Delayed encephalopathy with movement disorder and catatonia: A rare combination after wasp stings. Clin Neurol Neurosurg. 2012 Dec 21. [Medline].

  8. Ito K, Imafuku S, Nakayama J. Rhabdomyolysis due to Multiple Wasp Stings. Case Rep Dermatol Med. 2012. 2012:486724. [Medline]. [Full Text].

  9. Nandi M, Sarkar S. Acute kidney injury following multiple wasp stings. Pediatr Nephrol. 2012 Dec. 27(12):2315-7. [Medline].

  10. Barach EM, Nowak RM, Lee TG, et al. Epinephrine for treatment of anaphylactic shock. JAMA. 1984 Apr 27. 251(16):2118-22. [Medline].

  11. Brown SA, Seifert SA, Rayburn WF. Management of envenomations during pregnancy. Clin Toxicol (Phila). 2013 Jan. 51(1):3-15. [Medline].

  12. EpiPen EpiPen JR [package insert]. NAPA California: Dey. 2009.

  13. Ruëff F, Przybilla B. Venom immunotherapy. Side effects and efficacy of treatment. Hautarzt. Mar 2008. 59(3):200-5. [Medline].

  14. Ludman SW, Boyle RJ. Stinging insect allergy: current perspectives on venom immunotherapy. J Asthma Allergy. 2015. 8:75-86. [Medline].

  15. Vachvanichsanong P, Dissaneewate P. Acute renal failure following wasp sting in children. Eur J Pediatr. 2009 Aug. 168(8):991-4. [Medline].

  16. Rekik S, Andrieu S, Aboukhoudir F, Barnay P, Quaino G, Pansieri M, et al. ST Elevation Myocardial Infarction with No Structural Lesions after a Wasp Sting. J Emerg Med. 2009 Mar 26. [Medline].

  17. Jairam A, Kumar RS, Ghosh AK, Hasija PK, Singh JI, Mahapatra D, et al. Delayed Kounis syndrome and acute renal failure after wasp sting. Int J Cardiol. 2008 Aug 13. [Medline].

  18. Andrewes CH. The lives of Wasps and Bees. New York, NY: American Elsevier Publishing Co; 1969.

  19. Austen KF. Diseases of immediate sensitivity. Fauci AS, ed. Harrison's Principles of Internal Medicine. New York, NY: McGraw Hill; 1998. 1860-1869.

  20. Bohlke K, Davis RL, DeStefano F, Marcy SM, Braun MM, Thompson RS. Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization. J Allergy Clin Immunol. 2004 Mar. 113(3):536-42. [Medline].

  21. Boxer MB, Greenberger PA, Patterson R. The impact of prednisone in life-threatening idiopathic anaphylaxis: reduction in acute episodes and medical costs. Ann Allergy. 1989 Mar. 62(3):201-4. [Medline].

  22. Fadal RG. IgE-mediated hypersensitivity reactions. Otolaryngol Head Neck Surg. 1993 Sep. 109(3 Pt 2):565-78. [Medline].

  23. Golden DK. Immunology Allergy Clinics of North America. 2000. 20(3):553-570. [Full Text].

  24. Hauk P, Friedl K, Kaufmehl K, et al. Subsequent insect stings in children with hypersensitivity to Hymenoptera. J Pediatr. 1995 Feb. 126(2):185-90. [Medline].

  25. Li JT, Yunginger JW. Management of insect sting hypersensitivity. Mayo Clin Proc. 1992 Feb. 67(2):188-94. [Medline].

  26. Muellman RL, Lindzon RD, Silvers NS. Allergy, hypersensitivity and anaphylaxis. Rosen P, ed. Emergency Medicine, Concepts and Clinical Practice. 4th ed. St. Louis, Mo: Mosby Year Book; 1998. 2759-2776.

  27. Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report--second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med. 2006 Apr. 47(4):373-80. [Medline].

  28. Settipane GA, Boyd GK. Anaphylaxis from insect stings. Myths, controversy, and reality. Postgrad Med. 1989 Aug. 86(2):273-6, 278, 280-1. [Medline].

  29. Thomas M, Crawford I. Best evidence topic report. Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers. Emerg Med J. 2005 Apr. 22(4):272-3. [Medline].

A paper wasp (Randy Park, MD)
A paper wasp (Randy Park, MD)
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