31 consecutive cases referred to our clinical immunology/allergy
outpatient service from June 1, 1998 to June 30, 2002 were reviewed.
RESULTS: These patients comprised 3.5 percent of 889 cases referred during the study period. Their mean age was 28.8 +/- 10.5 (range 19-57) years and the majority were males (90.3 percent). Of these, 20 (64.5 percent) were Chinese, four (12.9 percent) were Malays and seven (22.6 percent) were of other races. 19 patients (61.3 percent) were men from the uniformed services including 12 (63.2 percent) full-time National Servicemen. 71 percent (22 patients) were stung for the first time.
Urticaria (22 cases, 71.0 percent), dyspnoea (13, 41.9 percent),
angioedema (12, 38.7 percent) and
syncope (ten, 32.3 percent) were the most common manifestations of insect
allergy.
Anaphylaxis occurred in 22 (71.0 percent) cases, constituting 30.1 percent of all cases of
anaphylaxis referred to our service during the study period. Although the causative insect was identified as honeybee (12, 38.7 percent), ant (four, 12.9 percent), wasp (three, 9.7 percent), and fire ant (two, 6.5 percent) by the majority of patients, ten (32.2 percent) patients were unable to identify the causative insect. The two patients stung by fire ants were Americans working in Singapore who had been stung while in the United States. Among those with
anaphylaxis, honeybee, wasp and fire ant
venom, for which specific
immunotherapy is available, were identified as the cause in 40.9 percent, 4.5 percent, and 4.5 percent, respectively.
CONCLUSION: