Reações alérgicas a ferroadas de insetos da classe Hymenoptera: uma revisão de literatura / Allergic reactions to hymenopteran stings: a literature review

Insetos como abelhas, vespas e formigas da ordem Hymenoptera podem causar reações alérgicas graves e até fatais. Esses insetos possuem venenos com componentes alergênicos e os injetam por meio de suas ferroadas, que podem causar reações locais e sistêmicas. O objetivo deste artigo é realizar uma revisão sistemática de literatura sobre as reações alérgicas às ferroadas de insetos da ordem Hymenoptera, com o intuito de analisar os mecanismos imunológicos envolvidos, as manifestações clínicas, os fatores de risco, os métodos de diagnóstico, as estratégias de prevenção e as opções terapêuticas disponíveis. Trata-se então de revisão sistemática de literatura realizada em agosto de 2023. O processo envolveu seis etapas. Os artigos foram obtidos pela busca em bases de dados, utilizando descritores em Ciências da Saúde relacionados ao tema. Foram identificados inicialmente 50 artigos, no entanto, apenas 10 deles atenderam aos critérios de inclusão. Para detecção das reações incluem-se testes cutâneos com venenos de Hymenoptera e análise do soro para IgE específica do veneno de Hymenoptera. Os fatores de risco que influenciam o resultado de uma reação anafilática incluem o intervalo de tempo entre as ferroadas, o número de ferroadas, a gravidade da reação anterior e o tipo de inseto. Esta revisão oferece uma visão abrangente das reações alérgicas às picadas de insetos Hymenoptera, contribuindo significativamente para o entendimento, diagnóstico e manejo dessas condições.

Insects of the order Hymenoptera such as bees, wasps, and ants can cause severe and even fatal allergic reactions. These insects have venom with allergenic components that they inject through their stingers, which can cause local and systemic reactions. This study aims to carry out a systematic literature review on allergic reactions to Hymenopteran stings, analyzing the immune mechanisms involved, clinical manifestations, risk factors, diagnostic methods, prevention strategies, and available therapeutic options. The literature review was conducted in August 2023, in a six-stage process. Articles were obtained by searching databases using Medical Subject Headings descriptors related to the topic. Initially, 50 articles were identified; however, only 10 of these met the inclusion criteria. We found that methods for detecting reactions include skin tests with Hymenopteran venoms and serum analysis for IgE specific to such venom. Risk factors that influence the outcome of anaphylactic reactions include the time interval between stings, the number of stings, the severity of the previous reaction, and the type of insect. This review provides a comprehensive overview of allergic reactions to Hymenopteran stings, contributing significantly to the understanding, diagnosis, and management of these conditions.

Generalized papular-purpuric eruption due to Solenopsis fugax bites

Abstract: A 59-year-old atopic man referred to for the onset of a diffused itching papular-purpuric eruption involving his trunk and legs but without systemic symptoms. History revealed that he started feeling itching after spending few hours in his basement. Direct examination of the environmental dust (www.edpa.it) showed high level of infestation of Solenopsis fugax, a small Myrmicinae ant. The skin eruption completely healed without scarring in 2 weeks. Specific disinfestation measures were performed and the patient did not comply of any recurrence during a 6-months follow-up.

Anaphylaxis caused by stings from the Solenopsis invicta, lava-pés ant or red imported fi re ant

Ants are social insects with species of medical interest, such as the fi re ants (Solenopsis sp.). The sting causes inflammation, vesicles and sterile pustules, which may cause allergic phenomena and even anaphylactic shock. We describe a patient who suffered a large number of stings and an episode of syncope with fall in blood pressure and complete regression of symptoms after resuscitation and medication for anaphylaxis. Considering the clinical manifestations and images of wheals and blisters on the patient’s feet at the time of syncope, this report should serve as a warning for the diagnosis and treatment of this condition and even for counseling and prevention regarding patients exposed to this risk.