Bee Sting Reactions

Can you describe the different kinds of reactions caused by bee stings?

Bee Sting Reactions

Dr. Greene’s Answer:

Bee venom contains at least nine different components that work together to cause reactions in those stung. When a bee injects its venom under the skin, the child may have immediate reactions (those symptoms beginning within 4 hours), delayed reactions (symptoms that don’t appear until more than four hours after the sting), or both. Classifying the reactions is important both for immediate management and for predicting future problems (Allergy Principles and Practice, Mosby 2003).

Some immediate reactions are classified as local (a two – or three-inch area of swelling, redness and pain that lasts less than 24 hours). Others qualify as large local reactions (those that are larger — often an entire limb — or that last longer, but all symptoms are adjacent to stings). Systemic reactions are allergic responses distant from the sting and include symptoms such as hives, generalized itching, generalized swelling, low blood pressure, difficulty breathing, or anaphylactic shock — a severe reaction involving most or all of these symptoms.

A sting on the forehead with swelling of the eyelids is a large local reaction, while a sting on the foot with swelling of the eyelids is a systemic reaction. Large local reactions are rarely serious and rarely portend future severe allergies. Systemic allergic reactions, though, are present and future warning signs.

A fourth type of immediate reaction is the toxic reaction, which can follow multiple stings. This is a direct result of bee venom, and not an allergic reaction. Symptoms can include fever, weakness, nausea, vomiting, and pain. Toxic reactions are rarely serious, but do sometimes sensitize the child and herald future allergic reactions.

Delayed reactions result when the body’s immune system prepares for future stings, but some of the exuberant defense measures inadvertently turn against the body itself. These symptoms begin more than four hours after the initial sting. Delayed reactions include serum sickness (fever, weakness, rash, swelling, and/or intense itching which begin a week after the sting), nephrotic syndrome (inflammation of the kidney), neuritis (inflammation of the nerves), or inflammation of other parts of the body.

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Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. katie

    I got stung last summer on the bottom of my foot near my big toe, and sometimes whilst im walking it still hurts. What do i do?

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  2. Ladylisa

    I was stung by a gang of hornets at least ten to 13 stings in Sept 17th of 2013. I had a terrible reaction of welts at every bit as well as pain took medicine and after a few days they went away but since then I’ve been having outbreaks of hives of which I never had before unless I took a birth control shot called depomovera but that’s been over ten years. So my question is can I still be having issues from the attack in September?

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  3. SmartGirl

    I was stung on the bottom of the foot two weeks ago (second ever bee sting) and it seemed to heal up fine. This morning though, intense itching woke me out of a sound sleep & when I rubbed my foot to scratch it the burning pain returned. The itch was so intense I had to put some Benadryl cream on it, and when I did, I noticed that at the site of the sting there is a small hard lump and what appears to be part of the stinger still under my skin.

    I have two autoimmune diseases (MS & RA) so I’m wondering if I should get this looked at by my GP, or just wait it out as my body absorbs or pushes out the remaining bit of stinger. I tried to gently squeeze it out (like a splinter) but it is far too tender.

    Any advice?

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  4. Jessica Champagne

    Dr. Green- first thank you for your time. My three year old presents with a history of yellow jacket sting three (plus) weeks ago behind upper left ear. Redness and swelling occurred immediately afterward and decreased over the next day or so. It was a large localized reaction the size of my hand.
    Today I happened to be looking in her ear and noticed that there is still a small reddened spot that she has obviously been scratching (scab with plasma exudate) at the exact site of the bee sting. (I had taken a photo of the redness and swelling and this is in the exact same spot as the sting) She has been crabby and clingy for the past two weeks (but what 3 year old isn’t?) In the last two days I have noticed a red rash to the left corner of her mouth, approx 2 inches in diameter. No fever that I have noticed (possible low grade that was undetected) eating, drinking, seems a bit more tired than usual. All this being said: Is it normal to have dermatological effects from yellow jacket venom so late after the sting? (Her Aunt supposedly had an anaphylactic reaction to bees as a child) Do you think a visit to an allergist should be in order. Or should I just keep an eye on it. Thank you so much.
    Just checked her lymph nodes and the ones just under her jaw are palpable but not super swollen. The left side larger than the right.
    Jessica

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  5. Sitarra winchell

    I was stung by a bee on the 20th of this month and 2 days ago it started itching and had raised up again. It looks like a rash is forming around it and it feels like it is on fire do I need to seek medical attention?

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  6. Cynthia Newell Cliffe

    I was stung about 3 weekend ago in my upper arm. It swelled up right away and turned bright red. It was about 3 to 4in wide and raised about 1 1/2 in high. It was very painful and went away about a week later. I started getting an bad itching sensation and scratched at my arm and it has a scab over it or something because I looked and I had a hole where the bee stung me. Today my arm started hurting again. The swelling is back and feels warm to touch. I also started hurting in my shoulder and under my shoulder blade. Should I seek medical attention?

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  7. Gav Mc

    I was stung on the finger by a wasp on Saturday Afternoon. About 2-3 hours later I began to feel nauseous. Now almost 48 hours later I still feel nauseous but have no other symptoms. I went to ER after 24hrs and the doc took my blood pressure and temp but nothing else and said he believed the nausea was unrelated to the sting. After 48hours am I now in the clear from Anaphylaxis from the sting?

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  8. Priyank

    Hello Dr Greene. My 15 months daughter got stung by a bee one week back. I immediately removed the stinger and rubbed some raw onion. After that I applied some baking soda paste and took her to hospital. There she was given 2 injections Avil 0.2 ml diluted and Bydroust 90 mg. She was under observation for couple of hours and then we came back home. She generally did not show any signs of any other side effect or reaction but there is some redness and hardness around the area where the bee stung (pic attached). Is there anything to worry about? Should I consult my Dr again? Please help.

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  9. penny marshall

    Dear dr green

    I was stung by a red wasp 2 weeks ago the sting hurt and had fever and as the day progressed started to swell. I took 2 benadryl and went to bed. When I woke up the next morning the swelling was worse and had spread to my hand I went to dr and they gave me a prednisone shot. Now 2 weeks later I have low grade fever and feel really tired. Went back to dr today and they fo not think it is delayed reaction to venum. What are your thoughts ?

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    • Alan Greene

      Penny, many things can cause low grade fever and fatigue – but it is important to know that delayed reactions to wasp stings, though uncommon, can last for weeks.

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  10. Alan Greene

    NRR, what an ordeal for your son and for you! Toxic reactions to multiple stings can produce symptoms including nausea, vomiting, diarrhea, headache, vertigo, fainting, and fever. And it is possible to have symptoms for weeks after the stings – and that don’t start for days or weeks. One reaction, serum sickness, typically starts 7-10 days later or so.

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  11. Alan Greene

    Tammy, you are right that the fatigue, nausea, and diarrhea could be signs of a reaction to being stung several days before. I’m a fan of everyone with systemic symptoms from stings being evaluated by a physician – both for that episode and to be prepared for the next one.

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  12. Alan Greene

    Hi AV. What you describe is consistent with a delayed response to the sting – and a good reason to be seen by an allergist to be prepared for any future stings.

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  13. Alan Greene

    MJ, still having a hard red 4 days after a sting is not unusual. I’m a fan of reactions that keep getting worse at that stage being checked by a physician.

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