RESUMO
A 48-year-old female received the bite of an unidentified insect in summer time. Almost immediately she experienced generalized pruritus. Then she developed urticaria, abdominal pain, nausea, angioedema on the face, and dyspnoea. Afterwards, in the out-patient department, she underwent an allergic screening through skin prick tests to Hymenoptera venom and dosage of specific IgE (Cap System). They revealed sensitization to Apis m, Vespula sp and Polistes sp. In fact the patient reported urticaria and angioedema after previous Hymenoptera stings. We performed a skin prick test with Tabanus extracts and obtained a positive reaction (wheal 5 mm). Later on, the patient captured the culprit insect and, after having consulted an entomologist, we were able to identify it as a fly from Hippoboscidae family: Hippobosca equina (H. e.). However, we cannot fully rely on skin prick tests and specific IgE, since for the time being the extract for H. e. allergy is not available. Our case is the first clinical report of an allergic reaction after the bite of Hippobosca. e in a patient with sensitization to Hymenoptera venom
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