Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
When warmer weather arrives, it is time to think about the return of
stinging insects. Over 2 million Americans are allergic to stinging insects.
While the severity of these allergic reactions varies greatly, they cause up to
150 deaths each year in the U.S. alone.
Stinging insects belong to the class Hymenoptera and include bees, hornets,
yellow jackets, wasps, and fire ants. Fire ants, which inflict a painful sting that belies their small size, are most common in the U.S. in the southeastern states, but they may have been introduced to other geographic areas throughout the country. All of the other stinging insects are found throughout the U.S. and Canada.
Most insect stings do not cause an allergic reaction,
but simply result in
pain, itching, redness, and swelling at the site of the sting. Cleaning the area
and application of ice packs to reduce swelling are often the only treatment
needed.
Most people who do have an allergy to stinging insects
have mild reactions, such as extension of the area of swelling around the sting. In a more serious
reaction, a person develops hives and itching all over the body.
Stinging insects found in the United States include honeybees, yellow jackets, hornets, wasps, and fire ants. While not everyone is allergic to insect venom, reactions in the skin such as mild pain, swelling, and redness may occur with an insect sting.
Who is at risk for insect sting allergies?
Over 2 million Americans are allergic to stinging insects. The degree of allergy varies widely. Most people are not allergic to insect stings, and most insect stings result in only local itching and swelling. Many, however, will have severe allergic reactions. Severe allergic reactions to insect stings are responsible for at least 50 deaths each year in the U.S.
If you are known to be allergic to insect stings, then the next sting is 60% likely to be similar or worse than the previous sting. Since most stings occur in the summer and fall, you are at greatest risk during these months. Males under the age of 20 are the most common victims of serious insect-sting allergic reactions, but this may reflect a greater exposure to insects of males, rather than a true predisposition.
What types of insect sting reactions occur?
Nonallergic reactions
Most insect-sting reactions are not allergic and result in
local pain, itching,
swelling, and redness at the site of the sting. Some extension
of the
swelling is expected. Local treatment is usually all that is
needed for
this type of reaction. Disinfect the area, keep it clean, and apply
ice. Topical corticosteroid creams are sometimes used to decrease inflammation, and antihistamines can help control itching.
Large local reactions may involve increased swelling (that lasts for 48 hours up to one week) that may be accompanied by nausea and vomiting. Large local reactions occur in about 10% of insect stings and are not allergic in origin. Occasionally, the site of an insect sting will become infected, and antibiotics are needed.
Allergic reactions
Systemic (body-wide) reactions are allergic responses and occur in people who have developed antibodies against the insect venom from a prior exposure. It is estimated that between 0.3%-3% of stings trigger a systemic allergic reaction.
The allergic reaction to an insect sting varies from person to person. Symptoms of an allergic reaction can include itching, hives, flushing of the skin, tingling or itching inside the mouth, and nausea or vomiting. The most serious allergic reaction is called anaphylaxis, which can be fatal. Difficulty breathing, swallowing, hoarseness, swelling of the tongue, dizziness, and fainting are signs of a severe allergic reaction. These types of reactions usually occur within minutes of the sting but have been known to be delayed for up to 24 hours. Prompt treatment is essential, and emergency help is often needed.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Anaphylaxis is a serious allergic reaction that affects a number of different areas of the body at one time, and can be fatal. Causes of anaphylaxis can be food allergy, latex allergy, allergy to insect or but stings/bites, asthma, or other materials or conditions. Symptoms include flushing, itching, hives, anxiety, rapid or irregular pulse. Severe symptoms may be throat and tongue swelling, swallowing, and difficulty breathing. Some disorders appear similar to anaphylaxis such as fainting, panic attacks, blood clots in the lungs, heart attacks, and septic shock. If you think that you may be having an anaphylactic reaction, seek emergency care or call 911 immedately.
The majority of spiders in the United States are harmless. Two exceptions include the black widow spider and the brown recluse spider. Symptoms of a harmless spider bite generally involve redness, irritation, and pain. alized symptoms of bites from black widow and brown recluse spiders may include: nausea and vomiting, fever, headache, abdominal pain, joint pain, and more. In general, a brown recluse spider bite or black widow spider bite may require medical attention. The information includes pictures of the brown recluse and black widow spiders for identification.
Chiggers are a mite belonging to the Trombiculidae family. Chiggers are most commonly found in grassy fields, gardens, parks, forests, and moist areas around lakes or rivers. Contrary to popular belief, chiggers do not burrow into the skin. Chiggers insert a feeding structure into the skin and inject enzymes that destroy host tissue. The chiggers then feed on this dead tissue. The most common symptom of a chigger bite is itching. Treatment generally includes antihistamines and calamine lotion.
Medical shock is a life-threatening medical condition. There are several types of medical shock, septic shock, anaphylactic shock, cardiogenic shock, hypovolemic shock, and neurogenic shock. Causes of shock include heart attack, heart failure, heavy bleeding (internal and external), infection, anaphylaxis, spinal cord injury, severe burns, chronic vomiting or diarrhea. Low blood pressure is the key sign of sock. Treatment is dependant upon the type of shock.
The most common cause of a black eye is due to an injury to the face or head. Most black eye injuries are minor and heal on their own, however, some may lead to significant injury. In addition to trauma to the face, cosmetic surgery can cause a black eye(s) as a side effect. People should be aware of the situations in which medical care should be sought immediately for a black eye.
Bees, wasps, and fire ants are related insects that belong to the Hymenoptera order. There are thousands of species of wasps found throughout the world. Common wasps are yellow jackets and hornets. Types of bees include honey bees, the Africanized honey bee (killer bee), and the bumble bee. There are four types of reactions to a bee or wasp sting; 1) local reaction, 2) systemic allergic reaction, 3) toxic reaction, and 4) delayed reaction. Individuals who have a systemic or toxic reaction generally require immediate medical treatment to prevent anaphylactic reaction, and possibly death.
Objects or insects in the ear can be placed in the ear by patients themselves, or an insect crawling in the ear. Ear wax can also cause ear problems if Q-tips are overused to clean the ears. Symptoms of an object in the ear are inflammation and sensitivity, redness, or discharge of pus or blood. When to seek medical care for an object or insect in the ear is included in the article information.
Most spiders do not have mouth parts strong enough to penetrate human skin, and the majority of spiders found in the U.S. and are actually harmless. There are two notable exceptions, the black widow spider and the brown recluse spider, which are both dangerous to humans. Spider bites are fortunately uncommon. In many cases, presumed spider bites are actually due to another skin condition or an insect sting.
The black widow and brown recluse spiders are more common in the southern states of the U.S. They prefer warm, dry climates and undisturbed areas such as basements, closets, woodpiles, attics, or under sinks. The black widow spider is a small, black, shiny spider with a red hourglass marking on its belly. The brown recluse spider is sometimes termed a "violin spider." It is about an inch long and has a marking resembling a violin on the upper part of its back. Bites from both the black widow and brown recluse spiders are dangerous to ...
When warmer weather arrives, it is time to think about the return of
stinging insects. Over 2 million Americans are 
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