Wasp or yellow jacket sting in Adult
Wasps are social insects, living in colonies, and they build paper nests, which they will fiercely defend. Yellow jackets build nests underground (Vespula) or aboveground in trees or buildings (Dolichovespula).
Wasp stings are the most common human envenomation. The stings from all species are similar, but hypersensitivity reactions may be quite specific. Wasps (including yellow jackets) can sting repeatedly, especially when trapped in clothing, because their stingers do not have barbs, like some bees.
Wasp venom is similar to bee venom, but the venoms are generally not cross-reactive. Wasp venom contains enzymes, small peptides, and amines. The allergens include the phospholipases, hyaluronidases, and cholinesterases. Some peptides cause histamine release by degranulating mast cells. Histamine, serotonin, and acetylcholine contribute to the pain associated with wasp stings.
Local wasp sting reactions include immediate pain, swelling, and redness at the sting site that often subsides within a few hours.
Regional reactions (exaggerated local reactions) occur in some individuals with extended swelling that can last 2-7 days. These reactions are not allergic in origin.
Anaphylactic reactions cause diffuse urticaria, pruritus, angioedema, bronchoconstriction, respiratory distress, hypotension, loss of consciousness, and cardiac arrhythmias. Typically, onset of life-threatening, anaphylactic signs will occur within 10 minutes of the sting.
Acute myocardial infarction, hepatitis, intravascular hemolysis, rhabdomyolysis, acute renal failure, and glomerulonephritis following a wasp sting have been rarely reported.
T63.461A – Toxic effect of venom of wasps, accidental, initial encounter
241819002 – Wasp sting
Differential Diagnosis & Pitfalls