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Summary  Background Insects are a very diverse group of animals and valuable members of any ecosystem. Allergies to bees and wasps (order: Hymenoptera) are well known in Europe. Allergies, toxicities, and the spread of diseases by other insects are also possible but quite frequently are not diagnosed. Sources A MEDLINE search on allergy caused by stinging and biting insects apart from bees and wasps was conducted. All relevant articles were evaluated, and a selection of relevant publications and cases from our outpatient units are used to illustrate our arguments. Content and implications Allergies to insects following bites and stings are common. Ant stings, mainly from imported fire ants, frequently lead to severe anaphylaxis, and their venom can elicit systemic toxic effects. Stings and bites of various other ant species can also lead to severe allergic reactions. Mosquito stings and horsefly or other Diptera stings may elicit severe local and IgE-mediated systemic reactions. True bugs (Hemiptera) are hematophagous insects and can also cause severe allergic reactions, in addition to being feared for transmitting diseases.

Part I: Insect stings and bites—Beyond the realm of bee and wasp allergies