Table 2: Classification of allergic reactions after HL Mueller, modified.

Reaction

Large local reactionSwelling at site of sting with diameter >10 cm, lasting >24 h

Grade IGeneralized urticaria, itching, malaise, anxiety

Grade IIAny of the above, plus two or more of the following: angiooedema (grade II also if alone), constriction in chest, nausea, vomiting, diarrhoea, abdominal pain, dizziness

Grade IIIAny of the above, plus two or more of the following: dyspnoea, wheezing, stridor (any of these alone are grade III), dysphagia, dysarthria, hoarseness, weakness, confusion, fear of death

Grade IVAny of the above, plus two or more of the following: drop of blood pressure, collapse, loss of consciousness, incontinence (urine, stool), cyanosis