A Very Big Hand Is a Very Big Problem: Soft-Tissue Infection, Venous Thrombosis, or Just an Insect Sting?
  • Sarah Damanti
    School of Specialization in Geriatrics and Gerontology, Università degli Studi di Milano, Milan
  • Barbara Brignolo-Ottolini
    School of Specialization in Geriatrics and Gerontology, Università degli Studi di Milano, Milan
  • Marta Mansi
    School of Specialization in Geriatrics and Gerontology, Università degli Studi di Milano, Milan
  • Maura Marcucci
    Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan Department of Clinical Sciences & Community Health, University of Milan, Milan
  • Daniela Mari
    Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan Department of Clinical Sciences & Community Health, University of Milan, Milan
  • Valerio Pravettoni
    Allergology and Immunology Unit, Fondazione IRCCS Ca’ Granda, Osp. Maggiore Policlinico, Milan

Keywords

Large local reaction, angioedema, anaphylaxis

Abstract

A 67-year-old woman developed severe edema of her right hand and forearm, for which she was treated with antibiotics, without benefit. The echography excluded a venous thrombosis. Subsequently, she referred a wasp sting before the development of the edema. Specific Hymenoptera venom immunoglobulin E (IgE) was found to be positive for paper wasp and yellow jacket. A large local reaction (LLR) was diagnosed due to the hymenoptera sting. Self-injectable epinephrine was prescribed for possible, though unlikely, systemic reactions following hymenoptera stings.

VIEW THE ENTIRE ARTICLE

References

  • Severino M, Bonadonna P, Passalacqua G. Large local reactions from stinging insects: from epidemiology to management. Curr Opin Allergy Clin Immunol 2009;9:334–337.
  • Przybilla B, Ruëff F. Insect Stings Clinical Features and Management. Dtsch Arztebl Int 2012;109:238–48.
  • Bonifazi F, Jutel M, Bilo BM, et al. The EAACI Interest Group on Insect Venom Hypersensitivity. Prevention and treatment of Hymenoptera venom allergy: guidelines for clinical practice. Allergy 2005;60:1459–1470.
  • Pucci S, D’Alò S, De Pasquale T, Illuminati I, Makri E, Incorvaia C. Risk of anaphylaxis in patients with large local reactions to hymenoptera stings: a retrospective and prospective study. Clin Mol Allergy 2015;13:21.

    • Views: 1428
    HTML downloads: 2866
    PDF downloads: 366
    Pictures downloads: 0
    MANUSCRIPT downloads: 0

    Published: 2016-02-18
    Issue: Vol. 3 No. 2 (view)

    How to cite:
    1.
    Damanti S, Brignolo-Ottolini B, Mansi M, Marcucci M, Mari D, Pravettoni V. A Very Big Hand Is a Very Big Problem: Soft-Tissue Infection, Venous Thrombosis, or Just an Insect Sting?. EJCRIM 2016;3 doi:10.12890/2016_000312.