Allergic responses to stinging vary from localized cutaneous reactions to systemic anaphylaxis. Systemic allergic responses to insects are attributed to IgE (immunoglobulin E) antibody -mediated responses, which are caused primarily by stings. Systemic reactions are identical to anaphylaxis from other triggers and may include symptoms of generalised urticaria, laryngeal edema, bronchospasm and hypotension. Diagnosis is generally evident from the history of exposure, typical symptoms and physical findings. Epinephrine is the drug of choice. Adjuvant treatment includes antihistaminics, corticosteroids, intravenous fluids and oxygen.