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
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
Факторы риска
- exposição ocupacional ou recreativa a insetos
- exposição geográfica a insetos
- história pregressa de resposta anafilática
Диагностические исследования
Исследования, которые показаны в первую очередь
- diagnóstico clínico
需考虑的检查
- triptase sérica
- teste de sensibilidade
- Hemograma completo
治疗流程
anafilaxia
reação local
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
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.
鉴别诊断
- Celulite
- Celulite orbitária e periorbitária
- Abscesso
更多 鉴别诊断指南
- Envenomation from tick bites and bee, wasp and ant stings
- 2024 American Heart Association and American Red Cross guidelines for first aid
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