Allergy to Insect Sting

ANSWER: D

This patient is experiencing a large local reaction to an insect sting. Symptoms usually worsen for 48 hours and may last up to 7 days. People who have had large local reactions to stings tend to have similar reactions after subsequent stings. The risk of anaphylaxis is less than 5% per episode. Immunotherapy will not prevent large local reactions, thus venom skin tests serve no purpose. An anaphylaxis emergency kit (Epi-Pen or Epi-Pen Jr.) is designed to treat anaphylactic reactions and would not be appropriate for this patient. Antihistamines and ibuprofen, with or without short-term steroid therapy, constitute appropriate treatment. Cellulitis rarely develops after an insect sting, and antibiotics are not indicated in most cases.

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