Vnitr Lek 2025, 71(6):353-358 | DOI: 10.36290/vnl.2025.067

Allergy to insect stings - clear rules, but also new questions

Martina Vachová
Ústav imunologie a alergologie, Fakultní nemocnice Plzeň a Lékařská fakulta v Plzni, Univerzita Karlova

The most serious clinical manifestation of insect venom allergy is life-threatening anaphylaxis. European epidemiological data clearly confirm that insect stings are the most common trigger of this severe systemic allergic reaction in adults, surpassing even medications and foods in this regard. Another manifestation of insect venom allergy is large local reaction around the site of the insect sting. From a clinical point of view, these reactions are significantly less serious than systemic reactions, but even extensive local swelling can bother the patient for several days. The aim of this article is to present current diagnostic and treatment procedures for patients with insect venom allergy. These procedures depend entirely on the nature of the reaction and vary significantly between patients with local and systemic allergic sting reactions. The severity of the reaction is decisive for the indication of allergological examination, determines the selection of emergency medication, and is essential in the indication of venom immunotherapy. Recommendations for patients who have already experienced an allergic insect sting reaction are clearly defined and are part of the basic knowledge of an allergist. However, the problem with insect sting allergies is that it is not possible to identify individuals at risk of this allergy in advance. This is due to the very high prevalence of so-called asymptomatic sensitization to insect venoms in the general population, which discredits the benefits of preventive screening for this type of allergy.

Keywords: hymenoptera venom allergy (HVA), molecular diagnostics (component resolved diagnostics, CRD), basophil activation test (BAT), systemic sting reaction (SR), large local reaction (LLR), venom immunotherapy (VIT), asymptomatic sensitization.

Accepted: September 21, 2025; Published: October 2, 2025  Show citation

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Vachová M. Allergy to insect stings - clear rules, but also new questions. Vnitr Lek. 2025;71(6):353-358. doi: 10.36290/vnl.2025.067.
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