Delayed stinging insect reactions

Systemic allergic reactions to stinging insects occur in approximately 1% of children and 3% of adults.1 Immunoglobulin E (IgE)-mediated reactions can present as systemic reactions or large local reactions.1 Systemic reactions present with symptoms related to urticaria, angioedema, airway obstruction, and hypotension (and sometimes abdominal pain, bronchospasm, or cardiac abnormalities) within 5 to 30 minutes after an insect sting.2 Large local reactions present as swelling of at least 10 cm in diameter that is contiguous with the sting site, increases in size for 1 to 2 days, and resolves over 5 to 10 days.

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