MANUAL MINORS
Wasp stings occur when the insect injects venom through its stinger. Unlike bees, wasps can sting multiple times without losing their stinger. Wasp stings cause an immediate local reaction, including sharp pain, redness, swelling, and, in some cases, severe allergic reactions like anaphylaxis. The venom contains toxins that can trigger inflammation and even systemic symptoms.
Diagnosis
Diagnosis is based on the appearance of a localised skin lesion, accompanied by stinging pain, swelling, and redness. In cases of allergic reactions, the patient may develop systemic symptoms such as hives, difficulty breathing, facial or throat swelling, dizziness, and in extreme cases, anaphylactic shock. The clinical history of contact with the wasp, along with observation of local and systemic signs, is key.
Differential Diagnosis
Condition | Key Difference |
|---|---|
Bee sting | Also causes pain and swelling, but bees leave the stinger embedded in the skin. |
Urticaria | Generalised itchy rashes without stings or envenomation. |
Cellulitis | Bacterial infection of subcutaneous tissues, with pain and redness progressing more slowly. |
Allergic reaction to food | May resemble anaphylaxis but without a recent sting. |
Emergency Management
In the emergency setting, management of a wasp sting includes cleaning the affected area with soap and water. Cold compresses can be applied to reduce inflammation. Pain and itching can be managed with oral antihistamines (e.g., diphenhydramine) and analgesics.
For more pronounced swelling, topical or oral corticosteroids can be used. If the patient shows signs of anaphylaxis, such as difficulty breathing, angioedema, or hypotension, intramuscular adrenaline should be administered immediately, usually in the thigh, and the patient should be quickly transferred to the hospital for advanced management.
Definitive Treatment
For local reactions, definitive treatment involves symptomatic management with antihistamines and corticosteroids, with follow-up until symptoms resolve. In cases of anaphylaxis, prolonged monitoring is necessary, and the patient should be prescribed an epinephrine auto-injector for future emergencies.
Patients should be educated on avoiding future stings and on the proper use of the auto-injector. Referral to an allergist may be considered to evaluate the possibility of immunotherapy to reduce the risk of severe reactions in the future.
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