With local reactions, outpatient treatment. With the development of anaphylactic shock, systemic and organ reactions, treatment and follow-up in hospital is indicated.
Therapeutic measures for allergies to insect bites include the earliest possible removal of the allergen from the body and a decrease in its absorption, symptomatic treatment and ASIT.
Elimination of the allergen. If there is a sting removed. A tourniquet is placed above the bite for 20 minutes and cold locally. It is necessary to ensure peace and elevation of the limb.
Medications. Antihistamines of the first and second generation, glucocorticosteroid hormones, pressor amines, bronchodilators and other medicines, shown to normalize the function of the affected organ or system, are used.
ASIT. Allergen-specific immunotherapy is carried out according to indications in the conditions of a specialized allergological cabinet.
Allergies to bites and stings of insects, as well as hyperreaction when in contact with their metabolic products (insect allergy) is found in every tenth inhabitant of our planet. The most dangerous is an allergic reaction to the poison of hymenoptera stinging insects, which often ends in anaphylactic shock and death. Sensitization to the poison of bees, wasps, and hornets often develops in young patients under the age of 20 years, including children and adolescents.
Causes of insect allergies
Most often acute allergic reactions occur when the hymenoptera bites are stinging insects: bees, bumblebees, wasps, hornets, as well as ants. The poison that enters the body during a bite contains a large amount of high-molecular-weight enzyme proteins, basic peptides, biogenic amines, which lead to the development of a whole cascade of undesirable reactions.
These are local changes in the bite zone (dilation of vessels and increase in their permeability, irritation of pain receptors), the toxic effect of the intake of poison and the allergic reaction itself.
When the bites of bloodsucking insects: mosquitoes, midges, gadflies, bedbugs, fleas, various biologically active elements penetrate the integuments with saliva, possessing a toxic, anticoagulant effect and often causing the development of hypersensitivity. Allergies can occur on the bites of beetles, cockroaches, some species of butterflies, as well as on contact with insects.
Pathogenesis of insect allergies
Sensitization with insect allergy develops in several ways: parenteral (with sting, bite), aerogenic (with air particles from the dust of insects and their excrement), contact, alimentary (with food).
The main mechanisms of the pathological process are due to the occurrence of allergic reactions of immediate type, immunocomplex and pseudo-allergic reactions.
With the immediate response of the immune system, specific IgE immunoglobulins are produced to a specific type of insect allergen. In this case, the symptoms of the disease usually appear in the first 10-20 minutes after the bite.
Immunocomplex type of reactions is accompanied by the synthesis of IgG and the formation of circulating immune complexes, with pseudo-allergy, the biologically active components contained in the venom and saliva of insects trigger the pathological process.
Symptoms of insect allergies
Clinical signs of allergy can be local (limited by the place of sting or bite), organ (characterized by dysfunction of target organs) and generalized, when the pathological process is systemic, disrupts the work of the whole organism and is a serious threat to life. Local changes are characterized by the appearance on the skin of a local focus of redness and edema, ranging in size from 7-10 centimeters in diameter, accompanied by severe skin itching. Sometimes papular rash, localized areas of necrosis, blisters can occur in the area of the bite. When scratching and rejection of the epidermis infection is possible.
Systemic manifestations of arthropod bite allergy can be mild (common rash, itching, anxiety), severe (dizziness, chest pain and bowel pain, dyspepsia), severe (hoarseness, shortness of breath, asphyxiation, fear of death, stupor).
In extremely severe cases, an anaphylactic reaction develops after a bite, with a pronounced decrease in blood pressure, loss of control over the function of the pelvic organs, the appearance of stupor and coma, respiratory arrest and cardiac activity, which in the absence of emergency care is fatal.
Organ manifestations of allergy are quite rare and are characterized by the development of vascular inflammation of the type of vasculitis, damage to the heart muscle, tissue of the kidneys, brain, joints, peripheral nervous system and the appearance of symptoms that occur in these diseases. Direct contact with the bodies of insects and their excrement sometimes leads to the appearance of symptoms of rhinoconjunctivitis, stomatitis, bronchospasm, dyspepsia.
Diagnosis of insect allergies
The main task of a specialist in the field of modern allergology at the stage of diagnosis is the thorough collection of anamnestic data (the presence of allergic reactions in the past when in contact with insects, finding out the fact of a bite, the type of arthropod, etc.), a careful clinical examination (identification of symptoms of skin lesions, signs of generalization and organ disorders).
If necessary, additional studies are appointed to help diagnose systemic and organ disorders (general and biochemical blood analysis, urinalysis, ECG, spirography, ultrasound of the abdominal organs, etc.).
Special tests are performed that are used in the diagnosis of allergic diseases. Among them are skin allergy tests with insect allergens (tests should be carried out only by an allergist in a specialized room), laboratory tests to identify specific immunoglobulins for allergens and other studies.
Differential diagnosis of insect sting allergy is carried out with other allergic reactions (urticaria, angioedema, rhinitis and conjunctivitis, bronchospastic conditions), contact dermatitis, various toxic reactions, diseases of internal organs. You may need to consult a dermatologist, cardiologist, nephrologist, rheumatologist and other specialists.
Prediction and prevention of insect allergies
With timely referral to a specialist and provision of qualified medical assistance, allergy to insect bites in most cases ends favorably with full recovery of working ability. With the development of severe systemic and organ lesions, the prognosis worsens.
Prevention includes sanitary and educational work, restriction of stay near apiaries and other places where insects can accumulate (fruit and vegetable markets, landfills, etc.), use of protective equipment (masks, nets, clothing), maintaining cleanliness in the premises, processing chemicals to repel and kill arthropods.
If you have a history of cases of allergy to insect bites, you should compile and carry with you the patient’s passport for an allergic disease and a set with medicines (antishock kit).