_IMMEDIATE:_ Pain
_LOCAL:_ Within 1-4 hours—Appearance and subsidence of wheal and red
flare; may see intense local swelling in region of sting
_SYSTEMIC:_
1. Mild reaction—Generalized urticaria, itching, malaise, anxiety
2. Moderate reaction—Any of the above plus generalized edema,
tightness in the chest, wheezing, abdominal pain, nausea,
vomiting, dizziness
3. Severe reaction—Any of the above plus labored breathing, difficulty
in swallowing, hoarseness or thickened speech, marked
weakness, confusion, feeling of impending disaster
4. Shock—Cyanosis, fall in BP, collapse, incontinence, unconsciousness
5. Delayed serum-sickness-like reaction (10-14 days after
sting)—Fever, lymphadenopathy, malaise, headache, urticaria,
polyarthritis
_ANAPHYLAXIS AND SUDDEN DEATH:_ Many cases reported, usually in adults