What are the challenges in testing for suspected insect bite or sting causing anaphylaxis?

Updated: May 16, 2018
  • Author: S Shahzad Mustafa, MD; Chief Editor: Michael A Kaliner, MD  more...
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Patients’ ability to identify the type of flying insect is unreliable (eg, many confuse yellow jackets and bees), generally mandating testing for all flying Hymenoptera. However, exceptions to this mandate can be made for patients whose stings were accompanied by sterile pustule formation within 24 hours (pathognomonic for fire ant sting) or for whom an impaled stinger and abdominal remnant were found at the sting site (the honeybee eviscerates itself as it stings). In these cases, testing may be limited to fire ant and honeybee allergen-specific IgE, respectively.

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