From the Guidelines
Skeeter syndrome is a severe allergic reaction to mosquito bites that requires immediate medical attention if symptoms such as breathing difficulties, dizziness, or widespread hives develop. This condition is characterized by significant swelling, redness, pain, and warmth at the bite site, and is caused by a heightened immune response to proteins in mosquito saliva, leading to the release of histamine and other inflammatory chemicals 1. Treatment typically involves oral antihistamines like diphenhydramine (Benadryl) 25-50mg every 6 hours or cetirizine (Zyrtec) 10mg daily to reduce itching and inflammation. For more severe reactions, topical corticosteroids such as hydrocortisone 1% cream applied 2-3 times daily can help reduce swelling, and cold compresses for 10-15 minutes several times daily can also provide relief 1.
In extreme cases with extensive swelling or systemic symptoms, oral corticosteroids like prednisone 20-40mg daily for 3-5 days may be necessary, but should be prescribed by a healthcare provider. Prevention is key and includes using insect repellents containing DEET or picaridin, wearing long-sleeved clothing, and avoiding outdoor activities during peak mosquito hours. It is essential to note that epinephrine is the drug of choice for the treatment of anaphylaxis, and patients with a history of systemic reactions to insect stings should carry epinephrine at an appropriate dosage for administration in case of a sting 1.
Some key points to consider in the management of Skeeter syndrome include:
- Avoiding insect stings by removing known or suspected nests, avoiding brightly colored clothing, and using insecticides approved for use on stinging insects 1
- Carrying epinephrine for emergency self-treatment and being familiar with proper use and indications 1
- Undergoing specific IgE testing for stinging insect sensitivity and considering immunotherapy (testing is optional for patients in whom VIT is not required) 1
- Considering obtaining and carrying a medical identification bracelet or necklace 1
Overall, the management of Skeeter syndrome requires a comprehensive approach that includes prevention, treatment, and education on insect avoidance and emergency medication use.
From the Research
Definition and Symptoms of Skeeter Syndrome
- Skeeter syndrome is a severe local allergic response to mosquito bites, accompanied by considerable inflammation and, in some cases, a systemic response like fever 2, 3.
- The reactions to mosquito bites are immunological reactions with involvement of IgE, IgG, and T cells mediated hypersensitivity, ranging from small local reactions, large local reactions to systemic allergic reactions 2.
- People with the syndrome develop serious allergies, ranging from rashes to anaphylaxis or shock 3.
Diagnosis and Treatment of Skeeter Syndrome
- Diagnosis is based on clinical history and physical examination, supported by the identification of specific IgE by skin testing 2.
- Treatment includes prevention, antihistamines, and steroids in some cases, while specific immunotherapy still requires further study 2, 4.
- A study on specific immunotherapy to mosquito bites showed a significant improvement of allergic symptoms, a decrease of symptom and drug consumption scores, and of allergen-specific nasal reactivity 4.
Prevention and Management of Allergic Reactions to Mosquito Bites
- Prevention of mosquito bites can be achieved through the use of insect repellents, such as DEET, and permethrin-treated clothing, which can provide protection against bites of nearly 100% 5.
- Management of allergic reactions to mosquito bites, including anaphylaxis, requires urgent airway monitoring and support, and may involve the use of epinephrine, corticosteroids, and antihistamines 6.