Approach to Patients with Stinging Insect Allergy

Elissa M. Abrams, David B.K. Golden

Research output: Contribution to journalReview article


Stinging insect allergy is uncommon but can be life threatening. Diagnosis requires clinical history and confirmative skin or blood testing by an allergist. Baseline serum tryptase level can be used to stratify risk. Treatment is supportive for all reactions except for anaphylaxis, which is treated with intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids, and oxygen. Venom immunotherapy is most effective for long-term management in patients with a history of anaphylaxis. Venom immunotherapy rapidly reduces the risk of sting anaphylaxis by up to 98% and maintenance treatment can be stopped after 5 years in most cases.

Original languageEnglish (US)
Pages (from-to)129-143
Number of pages15
JournalMedical Clinics of North America
Issue number1
StatePublished - Jan 2020



  • Anaphylaxis
  • Large local reaction
  • Stinging insect
  • Venom immunotherapy

ASJC Scopus subject areas

  • Medicine(all)

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