Book contents
- Frontmatter
- Contents
- CONTRIBUTORS
- PREFACE
- Chap. 1 CELL INJURY AND CELL DEATH
- Chap. 2 CLEAN AND ASEPTIC TECHNIQUE AT THE BEDSIDE
- Chap. 3 NEW ANTIMICROBIALS
- Chap. 4 IMMUNOMODULATORS AND THE “BIOLOGICS” IN CUTANEOUS EMERGENCIES
- Chap. 5 CRITICAL CARE: STUFF YOU REALLY, REALLY NEED TO KNOW
- Chap. 6 ACUTE SKIN FAILURE: CONCEPT, CAUSES, CONSEQUENCES, AND CARE
- Chap. 7 CUTANEOUS SYMPTOMS AND NEONATAL EMERGENCIES
- Chap. 8 NECROTIZING SOFT-TISSUE INFECTIONS, INCLUDING NECROTIZING FASCIITIS
- Chap. 9 LIFE-THREATENING BACTERIAL SKIN INFECTIONS
- Chap. 10 BACTEREMIA, SEPSIS, SEPTIC SHOCK, AND TOXIC SHOCK SYNDROME
- Chap. 11 STAPHYLOCOCCAL SCALDED SKIN SYNDROME
- Chap. 12 LIFE-THREATENING CUTANEOUS VIRAL DISEASES
- Chap. 13 LIFE-THREATENING CUTANEOUS FUNGAL AND PARASITIC DISEASES
- Chap. 14 LIFE-THREATENING STINGS, BITES, AND MARINE ENVENOMATIONS
- Chap. 15 SEVERE, ACUTE ADVERSE CUTANEOUS DRUG REACTIONS I: STEVENS–JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS
- Chap. 16 SEVERE, ACUTE ADVERSE CUTANEOUS DRUG REACTIONS II: DRESS SYNDROME AND SERUM SICKNESS-LIKE REACTION
- Chap. 17 SEVERE, ACUTE COMPLICATIONS OF DERMATOLOGIC THERAPIES
- Chap. 18 SEVERE, ACUTE ALLERGIC AND IMMUNOLOGICAL REACTIONS I: URTICARIA, ANGIOEDEMA, MASTOCYTOSIS, AND ANAPHYLAXIS
- Chap. 19 SEVERE, ACUTE ALLERGIC AND IMMUNOLOGICAL REACTIONS II: OTHER HYPERSENSITIVITIES AND IMMUNE DEFECTS, INCLUDING HIV
- Chap. 20 GRAFT VERSUS HOST DISEASE
- Chap. 21 ERYTHRODERMA/EXFOLIATIVE DERMATITIS
- Chap. 22 ACUTE, SEVERE BULLOUS DERMATOSES
- Chap. 23 EMERGENCY MANAGEMENT OF PURPURA AND VASCULITIS, INCLUDING PURPURA FULMINANS
- Chap. 24 EMERGENCY MANAGEMENT OF CONNECTIVE TISSUE DISORDERS AND THEIR COMPLICATIONS
- Chap. 25 SKIN SIGNS OF SYSTEMIC INFECTIONS
- Chap. 26 SKIN SIGNS OF SYSTEMIC NEOPLASTIC DISEASES AND PARANEOPLASTIC CUTANEOUS SYNDROMES
- Chap. 27 BURN INJURY
- Chap. 28 EMERGENCY DERMATOSES OF THE ANORECTAL REGIONS
- Chap. 29 EMERGENCY MANAGEMENT OF SEXUALLY TRANSMITTED DISEASES AND OTHER GENITOURETHRAL DISORDERS
- Chap. 30 EMERGENCY MANAGEMENT OF ENVIRONMENTAL SKIN DISORDERS: HEAT, COLD, ULTRAVIOLET LIGHT INJURIES
- Chap. 31 ENDOCRINOLOGIC EMERGENCIES IN DERMATOLOGY
- Chap. 32 EMERGENCY MANAGEMENT OF SKIN TORTURE AND SELF-INFLICTED DERMATOSES
- Chap. 33 SKIN SIGNS OF POISONING
- Chap. 34 DISASTER PLANNING: MASS CASUALTY MANAGEMENT
- Chap. 35 CATASTROPHES IN COSMETIC PROCEDURES
- Chap. 36 LIFE-THREATENING DERMATOSES IN TRAVELERS
- Index
- References
Chap. 14 - LIFE-THREATENING STINGS, BITES, AND MARINE ENVENOMATIONS
Published online by Cambridge University Press: 07 September 2011
- Frontmatter
- Contents
- CONTRIBUTORS
- PREFACE
- Chap. 1 CELL INJURY AND CELL DEATH
- Chap. 2 CLEAN AND ASEPTIC TECHNIQUE AT THE BEDSIDE
- Chap. 3 NEW ANTIMICROBIALS
- Chap. 4 IMMUNOMODULATORS AND THE “BIOLOGICS” IN CUTANEOUS EMERGENCIES
- Chap. 5 CRITICAL CARE: STUFF YOU REALLY, REALLY NEED TO KNOW
- Chap. 6 ACUTE SKIN FAILURE: CONCEPT, CAUSES, CONSEQUENCES, AND CARE
- Chap. 7 CUTANEOUS SYMPTOMS AND NEONATAL EMERGENCIES
- Chap. 8 NECROTIZING SOFT-TISSUE INFECTIONS, INCLUDING NECROTIZING FASCIITIS
- Chap. 9 LIFE-THREATENING BACTERIAL SKIN INFECTIONS
- Chap. 10 BACTEREMIA, SEPSIS, SEPTIC SHOCK, AND TOXIC SHOCK SYNDROME
- Chap. 11 STAPHYLOCOCCAL SCALDED SKIN SYNDROME
- Chap. 12 LIFE-THREATENING CUTANEOUS VIRAL DISEASES
- Chap. 13 LIFE-THREATENING CUTANEOUS FUNGAL AND PARASITIC DISEASES
- Chap. 14 LIFE-THREATENING STINGS, BITES, AND MARINE ENVENOMATIONS
- Chap. 15 SEVERE, ACUTE ADVERSE CUTANEOUS DRUG REACTIONS I: STEVENS–JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS
- Chap. 16 SEVERE, ACUTE ADVERSE CUTANEOUS DRUG REACTIONS II: DRESS SYNDROME AND SERUM SICKNESS-LIKE REACTION
- Chap. 17 SEVERE, ACUTE COMPLICATIONS OF DERMATOLOGIC THERAPIES
- Chap. 18 SEVERE, ACUTE ALLERGIC AND IMMUNOLOGICAL REACTIONS I: URTICARIA, ANGIOEDEMA, MASTOCYTOSIS, AND ANAPHYLAXIS
- Chap. 19 SEVERE, ACUTE ALLERGIC AND IMMUNOLOGICAL REACTIONS II: OTHER HYPERSENSITIVITIES AND IMMUNE DEFECTS, INCLUDING HIV
- Chap. 20 GRAFT VERSUS HOST DISEASE
- Chap. 21 ERYTHRODERMA/EXFOLIATIVE DERMATITIS
- Chap. 22 ACUTE, SEVERE BULLOUS DERMATOSES
- Chap. 23 EMERGENCY MANAGEMENT OF PURPURA AND VASCULITIS, INCLUDING PURPURA FULMINANS
- Chap. 24 EMERGENCY MANAGEMENT OF CONNECTIVE TISSUE DISORDERS AND THEIR COMPLICATIONS
- Chap. 25 SKIN SIGNS OF SYSTEMIC INFECTIONS
- Chap. 26 SKIN SIGNS OF SYSTEMIC NEOPLASTIC DISEASES AND PARANEOPLASTIC CUTANEOUS SYNDROMES
- Chap. 27 BURN INJURY
- Chap. 28 EMERGENCY DERMATOSES OF THE ANORECTAL REGIONS
- Chap. 29 EMERGENCY MANAGEMENT OF SEXUALLY TRANSMITTED DISEASES AND OTHER GENITOURETHRAL DISORDERS
- Chap. 30 EMERGENCY MANAGEMENT OF ENVIRONMENTAL SKIN DISORDERS: HEAT, COLD, ULTRAVIOLET LIGHT INJURIES
- Chap. 31 ENDOCRINOLOGIC EMERGENCIES IN DERMATOLOGY
- Chap. 32 EMERGENCY MANAGEMENT OF SKIN TORTURE AND SELF-INFLICTED DERMATOSES
- Chap. 33 SKIN SIGNS OF POISONING
- Chap. 34 DISASTER PLANNING: MASS CASUALTY MANAGEMENT
- Chap. 35 CATASTROPHES IN COSMETIC PROCEDURES
- Chap. 36 LIFE-THREATENING DERMATOSES IN TRAVELERS
- Index
- References
Summary
BITES AND STINGS
Major causes of death related to arthropod bites and stings include anaphylaxis, reactions to venom, and vector-borne disease. This chapter addresses each of these causes.
ANAPHYLAXIS
Background
Anaphylaxis related to insect stings is estimated to occur in 3 of every 100 adults.
Clinical and Laboratory
Skin tests can be used to verify a history of sting allergy. Radioallergosorbent testing (RAST) is less sensitive, but does not carry a risk of anaphylaxis during the testing. It is important to note that neither the size of a skin test reaction nor the RAST level is a reliable predictor of the severity of subsequent sting reactions. In vitro methods of testing also include western blot and in vitro basophil activation tests that measure histamine and sulphidoleukotrien released (Cellular Antigen Stimulation Test [CAST]) or activation markers on the cell surface detected by means of flow cytometric analysis (Flow CAST). Basophil activation tests using either CD63 or CD203c show promise in the in vitro diagnosis of patients with bee or wasp venom allergy.
Patients with mastocytosis who develop severe hypotension after wasp or bee stings typically do not demonstrate specific immunoglobulin E (IgE). Similar patients have been described with no skin lesions to suggest mastocytosis. In some patients, serum tryptase elevations suggest subclinical mastocytosis, and bone-marrow biopsy may reveal systemic mastocytosis.
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- Emergency Dermatology , pp. 146 - 153Publisher: Cambridge University PressPrint publication year: 2011