title: Mosquito bite anaphylaxis: immunotherapy with whole body extracts.
abstract: BACKGROUND
  Adverse reactions to mosquito bites have been recognized for some time. These usually consist of large local swellings and redness, generalized urticaria, angioedema and less easily definable responses such as nausea, dizziness, headaches, and lethargy.
  
  
  METHODS
  We report two patients who experienced systemic anaphylaxis from mosquito bites. Both were skin tested and given immunotherapy using whole body mosquito extracts.
  
  
  RESULTS
  Skin testing using whole body mosquito extracts was positive to Aedes aegypti at 1/1,000 weight/volume (wt/vol) in one patient and to Aedes aegypti at 1/100,000 wt/vol, and Culex pipiens at 1/10,000 wt/vol in the other. Skin testing of ten volunteers without a history of adverse reactions to mosquito bites was negative. Immunotherapy using these extracts resulted in resolution of adverse reactions to mosquito bites in one patient and a decrease in reactions in the other.
  
  
  CONCLUSIONS
  Immunotherapy with whole body mosquito extracts is a viable treatment option that can play a role in patients with mosquito bite-induced anaphylaxis. It may also result in severe side effects and one must determine the benefit versus risks for each individual patient.
authors.affiliation: Allergy & Immunology Service, Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: McCormack
authors.forename: K F
authors.initials: KF
authors.lastname: Salata
authors.forename: J N
authors.initials: JN
authors.lastname: Hershey
authors.forename: G B
authors.initials: GB
authors.lastname: Carpenter
authors.forename: R J
authors.initials: RJ
authors.lastname: Engler
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000209:etiology* / Q000628:therapy*; D000818:Animals; D009033:Culicidae / Q000276:immunology; D006801:Humans; D007167:Immunotherapy; D007299:Insect Bites and Stings / Q000150:complications*; D008297:Male; D012882:Skin Tests; D014020:Tissue Extracts / Q000276:immunology
chemical_list: D014020:Tissue Extracts