1/25. serum sickness-like syndrome due to mosquito bite.Local inflammatory reactions at the site of a mosquito bite are frequent. Immediate systemic reactions have occasionally been reported. The first case of a patient with relapsing episodes of a serum sickness-like syndrome following mosquito bites is reported herein. A 62-year-old patient came to the emergency room complaining of sudden malaise, chills, fever, headache, cervical lymph node enlargement, arthromyalgia, generalized purpura and leukopenia 6 h after a mosquito bite. He had experienced multiple similar episodes in the last 20 years, also following mosquito bites. Infectious and autoimmune diseases were ruled out. Serum IgE was 9,102 kU/l. Prick test of whole-body culex pipiens extract was positive. Specific IgE to aedes communis was 2.25 kU/l. SDS-PAGE immunoblotting of the patient's serum with whole-body C. pipiens extract revealed 43 and 17 kDa IgG-binding proteins and 22 and 17 kDa IgE-binding proteins, neither of which were found with control sera. Skin biopsy was consistent with leukocytoclastic vasculitis. The presence of both mosquito-specific IgE and IgG in the patient's serum suggest a possible cooperative immune response leading to clinical manifestations of serum sickness.- - - - - - - - - - ranking = 1keywords = sickness (Clic here for more details about this article) |
2/25. Fire ant attacks on residents in health care facilities: a report of two cases.BACKGROUND: Imported fire ants now infest more than 310 million acres in the united states and puerto rico. Colonies have been found in arizona, california, new mexico, and virginia. Available reports suggest that each year, fire ants sting more than 50% of persons in endemic areas, resulting in a variety of medical consequences. OBJECTIVE: To describe fire ant attacks among patients in health care facilities. DESIGN: Case series and literature review. SETTING: Two nursing homes in mississippi. patients: Two nursing home residents. MEASUREMENTS: Clinical records to describe clinical sequelae of multiple stings. RESULTS: With the 2 incidents reported here, the total number of reported indoor fire ant attacks on humans since 1989 is 10. Six of the persons attacked, including the 2 nursing home residents described here (who died after the stings), had preexisting neurologic impairment. Eight of the 10 attacks have been reported in the past 4 years. CONCLUSIONS: The presence of fire ants in occupied dwellings indicates the presence of active fire ant colonies in the immediate proximity. Efforts to eradicate these insects should be undertaken immediately, especially if immobile persons are present. These persons should be considered at risk for fire ant attacks as long as the ants are present.- - - - - - - - - - ranking = 0.017569093477013keywords = person (Clic here for more details about this article) |
3/25. Oropharyngeal hymenoptera stings: a special concern for airway obstruction.hymenoptera stings are common and cause 40 to 50 deaths each year. hymenoptera venom contains a variety of toxic and allergenic substances that can produce many types of both local and systemic reactions. Of these, anaphylaxis is the most feared and the most common cause of sting-related deaths. Oropharyngeal stings, although rare, have the added potential to produce life-threatening airway obstruction via localized swelling. This threat is of particular concern to military personnel who operate in environments where stings are more likely to occur and where emergency medical resources are limited or lacking. This risk can be minimized if such victims are treated early and aggressively, even though they may initially present with minimal symptoms.- - - - - - - - - - ranking = 0.0043922733692533keywords = person (Clic here for more details about this article) |
4/25. Unusual reactions following insect stings. Clinical features and immunologic analysis.Fifteen patients were studied who had unusual reactions following insect stings. These included serum sickness, neurologic disease, renal disease, and delayed hypersensitivity-type reactions. The clinical features are briefly outlined. Measurements were made of serum venom-specific IgE and IgG antibodies. These antibodies were present in some patients and in these instances suggested an immunologic pathogenesis for the reactions. Alternative etiologies for the unusual reactions are also discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = sickness (Clic here for more details about this article) |
5/25. food-dependent exercise-induced anaphylaxis.A 58-year-old farmer was admitted to our hospital because of repeated episodes of anaphylaxis. He had experienced 12 episodes of anaphylactic shock over the previous 17 years. These attacks included three episodes of bee sting. In general, the episodes occurred during farm work (exercise) and within two hours of eating cake in the afternoon. Because an immediate skin reaction to wheat flour was highly positive, a diagnosis of wheat allergy was considered. These findings suggested that his illness was consistent with food-dependent exercise-induced anaphylaxis.- - - - - - - - - - ranking = 0.00034495853376455keywords = illness (Clic here for more details about this article) |
6/25. Management of insect sting hypersensitivity.Approximately 1 to 3% of the general population has had a systemic reaction to insect stings. Adults whose reactions include urticaria, obstruction of the upper or lower airway, or hypotension and children whose reactions include obstruction of the upper or lower airway or hypotension have an increased risk of future systemic reactions to stings. Allergy skin tests to hymenoptera venoms can help to identify the offending insect and to classify the reactions as allergic; however, because 15% of the general population may have positive results to such tests, persons who have not experienced a systemic reaction to insect stings should not be tested. Venom immunotherapy is highly effective and confers 98 to 99% protection in patients who have experienced previous systemic reactions to insect stings. Reaction rates to venom skin tests or venom immunotherapy are low and are similar to those in allergy testing and immunotherapy for hay fever. Generally, patients who have had systemic reactions to stings should be assessed by an allergist to determine whether they are candidates for immunotherapy with hymenoptera venom. The decision to institute venom immunotherapy should be based on the disposition of the patient, the severity of the reaction, and the risk of subsequent stings. Deliberate sting challenges are clinically useful for guiding immunotherapy.- - - - - - - - - - ranking = 0.0043922733692533keywords = person (Clic here for more details about this article) |
7/25. Acute polyradiculoneuropathy occurring after hymenoptera stings: a clinical case study.hymenoptera stings may be responsible for both local and systemic reactions; these can be immediate or delayed, depending on the time between the sting and the development of signs or symptoms. Delayed clinical reactions have been reported, although unusual, due to serum sickness and/or affecting organs or systems generally not involved in the immediate reaction, such as heart, kidneys, central and peripheral nervous systems. This paper describes the clinical and immunological findings in a 51-year-old subject, who, after two stings of paper wasps, the second one after the third venom immunotherapy (VIT) injection, presented immediate large local and systemic allergic reactions which quickly improved after e.v. methylprednisolone administration. About 40 hours later, he developed acute polyradiculoneuropathy with muscle weakness, paresthesia, difficulties in standing up and walking. skin tests and specific IgE determination showed allergy to paper wasp. The activation, by wasp venom, of peripheral blood mononuclear cells in primary culture, evaluated by tritiated thymidine incorporation proliferation assay, showed an important hypersensitivity to wasp venom. Therefore our results suggest the hypothesis that the polyradiculoneuritis causative etiopathogenetic mechanism might be a delayed immunological response to wasp antigens followed by an allergy-triggered autoimmune reaction, as previously suggested by other authors; they found lymphocytic infiltrates in demyelinization areas and at perivascular levels, by histologic examination of autoptical and bioptical material of patients with nervous system lesions after hymenoptera stings.- - - - - - - - - - ranking = 0.16666666666667keywords = sickness (Clic here for more details about this article) |
8/25. nephrotic syndrome with focal segmental glomerulosclerosis after an insect bite.AIMS AND methods: Focal segmental glomerulosclerosis (FSGS) is a glomerular disease defined by a characteristic histologic pattern that occurs either as a primary kidney disease (primary FSGS) or as a result of a systemic illness (secondary FSGS). proteinuria, often in the nephrotic range, is the hallmark of FSGS. The occurrence of nephrotic syndrome after an insect sting is rarely reported in the literature. We present a case of nephrotic syndrome with focal segmental glomerulosclerosis with a glomerular tip lesion developing after an insect bite. RESULTS: A 51-year-old Caucasian female was bitten by an insect on her left leg, which immediately became swollen. Generalized edema developed and she was admitted for further investigations. Urinary 24-h protein excretion was 7 g. Percutaneous renal biopsy was performed and showed focal segmental glomerulosclerosis of the tip variant. nephrotic syndrome was steroid-resistant, and when we added cyclophosphamide for 8 weeks complete remission was achieved. There was no relapse of the disease during the 2-month follow-up. CONCLUSIONS: This report demonstrates the useful role of cyclophosphamide in the treatment of steroid-resistant nephrotic syndrome due to FSGS with glomerular tip lesion. A causal relationship between the insect bite and the nephrotic syndrome is suggested and an immune response could be responsible for the nephrotic syndrome.- - - - - - - - - - ranking = 0.00034495853376455keywords = illness (Clic here for more details about this article) |
9/25. African tick bite fever: a not-so-uncommon illness in international travelers.BACKGROUND: African tick bite fever is a rickettsial illness that has recently emerged as a significant disease among international travelers. The vector is the Amblyomma tick, which is endemic to sub-Saharan africa and parts of the eastern Caribbean. OBSERVATIONS: We describe a middle-aged woman who returned from a mission trip to zimbabwe with an influenzalike illness and inoculation eschar; she also had a history of travel to a game farm. biopsy revealed a histopathologic pattern consistent with an infectious pathogenesis. Immunohistochemical staining confirmed the presence of rickettsial organisms. In light of the patient's history, the clinical constellation of signs and symptoms, and the results of ancillary laboratory testing, a diagnosis of African tick bite fever was made. The patient was treated with doxycycline hydrochloride and had an uncomplicated course. CONCLUSIONS: This report further highlights the epidemiological and clinical features of African tick bite fever. With the increase in international travel, it is important to recognize the illness in those who have been to endemic countries and to counsel patients regarding preventive measures for planned travel.- - - - - - - - - - ranking = 0.0024147097363518keywords = illness (Clic here for more details about this article) |
10/25. Unusual reactions to insect venoms.A variety of unusual, unexpected reactions have been described that occur in a temporal relationship to venom exposure, primarily insect stings. An immunologic mechanism appears responsible for reactions such as serum sickness and late onset allergiclike symptoms. In all probability, allergic mechanisms are responsible for the renal and neurologic symptoms and the delayed hypersensitivity type reactions. The mechanisms for the fatigue and malaise following venom injections and the most unusual areas of extensive erythema following venom skin tests are not known.- - - - - - - - - - ranking = 0.16666666666667keywords = sickness (Clic here for more details about this article) |
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