Sting challenge

A sting test consists in performing a controlled sting challenge with a live insect. The procedure is carried out to objectively assess clinical tolerance of stinging insects’ venom. For practical reasons, the test is mostly applied to assess the success of venom immunotherapy in patients treated for bee venom allergy, and in rarer cases for wasp venom allergy. Sting tests should not be performed for predictive and/or diagnostic purposes in patients who do not manifest allergic symptoms to insect venoms, whose allergic symptoms are local, and in patients with asymptomatic venom allergy. Some major limitations of the sting test are: a significant risk of anaphylaxis, low repeatability of the test with a live wasp, no way to double-blind the test and to compound clinical reaction to venom (booster effect). Additionally, a sting test has to be carried out by medical staff experienced in performing sting challenges with full resuscitation facilities. A hospital intensive care unit is recommended for this procedure.