Venom Anaphylaxis.

Allergy to venoms of stinging insects (bees, yellow jackets, hornets, wasps, and stinging ants) causes large local reactions or systemic reactions, including anaphylaxis. Diagnostic evaluation includes skin testing and/or serum venom-specific IgE and basal serum tryptase (to identify underlying mast cell disorders). Patients with sting anaphylaxis should be prescribed epinephrine and venom immunotherapy which prevents allergic reactions in up to 98% of patients. Most patients may safely discontinue venom immunotherapy after 5 years, although high-risk patients need to continue indefinitely. Further research is needed to improve the predictive value of diagnostic testing and the safety and efficacy of treatment.