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Picadas e ferroadas de insetos

Последний просмотренный: 18 Aug 2025
Last updated: 06 Dec 2024

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • picada/ferroada testemunhada
  • edema local
  • dor local
  • calor no local
  • marcas locais
  • prurido
  • pápula e eritema
  • palidez cutânea
  • sudorese
  • sinais de comprometimento das vias aéreas
  • edema orofaríngeo
  • dispneia
  • estertores/crepitações/sibilos
  • taquicardia
  • pulso irregular
  • rubor cutâneo
  • estado de alerta alterado
Полная информация

Другие диагностические факторы

  • pústulas
  • erupção cutânea em formato de olho-de-boi
  • erupção cutânea nas palmas das mãos e solas dos pés
  • erupção cutânea linear elevada
  • hipertensão
  • febre
  • cãibra muscular
  • diaforese
  • tremor
  • parestesia e/ou fasciculações
  • dor generalizada
  • náuseas/vômitos
  • cefaleia
  • dor abdominal
  • história de pacientes imunocomprometidos
  • história de doença cardiovascular
  • abscesso
  • necrose
  • tosse
  • hipotensão
  • artralgia
  • adenopatia
Полная информация

Факторы риска

  • exposição ocupacional ou recreativa a insetos
  • exposição geográfica a insetos
  • história pregressa de resposta anafilática
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • diagnóstico clínico
Полная информация

需考虑的检查

  • triptase sérica
  • teste de sensibilidade
  • Hemograma completo
完整详情

治疗流程

初步治疗

anafilaxia

急症处理

reação local

持续性治疗

infecção secundária

撰稿人

作者

David B. K. Golden, MDCM

Associate Professor of Medicine

John Hopkins University

Baltimore

MD

利益声明

DG has received consultant fees from Novartis, rAquestive, Kokua, and Celldex (all related to anaphylaxis); clinical trial support from Genentech, GSK, Merck, Lilly, Teva, Sanofi, Regeneron, Novartis, AstraZeneca, and Pfizer (all related to non-anaphylaxis disease states); and royalties from UpToDate (related to insect allergy).

Karla E. Adams, MD

Associate Professor of Pediatrics

Uniformed Services University

Department of Medicine, Allergy and Immunology Division, Wilford Hall Ambulatory Surgical Center

San Antonio

TX

利益声明

KA received an honorarium and paid travel expenses to present lectures at the Eastern Allergy Conference and the Louisiana Society of Allergy, Asthma and Immunology on the topic of insect allergy in 2024.

鸣谢

David B.K. Golden and Karla E. Adams would like to gratefully acknowledge Tom Morrissey, a previous contributor to this topic.

利益声明

Not disclosed.

同行评议者

Theodore M. Freeman, MD

Allergist and Immunologist

Jacobs Ramirez and Freeman Allergy & Immunology

San Antonio

TX

利益声明

TMF is an author of a number of references cited in this topic.

Andrew Parfitt, MBBS, FFAEM

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

利益声明

AP declares that he has no competing interests.

Richard DeShazo, MD

Chairman and Professor

Department of Medicine

Professor of Pediatrics

Billy S. Guyton Distinguished Professor

University of Mississippi Medical Center

Jackson

MS

利益声明

RD is an author of a reference cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis - a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020 Apr;145(4):1082-123.全文  摘要

Golden DBK, Wang J, Waserman S, et al. Anaphylaxis: a 2023 practice parameter update. Ann Allergy Asthma Immunol. 2024 Feb;132(2):124-76.全文  摘要

Golden DB, Demain J, Freeman T, et al. Stinging insect hypersensitivity: a practice parameter update 2016. Ann Allergy Asthma Immunol. 2017 Jan;118(1):28-54. 摘要

Sturm GJ, Varga EM, Roberts G, et al. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy. 2018 Apr;73(4):744-764.全文  摘要

Biló BM, Rueff F, Mosbech H, et al. Diagnosis of Hymenoptera venom allergy. Allergy. 2005 Nov;60(11):1339-49.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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