Skeeter syndrome,☆☆,,★★

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CASE STUDIES

We studied 5 otherwise healthy 2- to 4-year-old children with no history of allergy to insect bites who were consecutively referred to the Children’s Hospital Allergy Clinic after being diagnosed by their different primary care physicians with “cellulitis,” which developed within hours at the site of a witnessed mosquito bite (Fig 1).

. At age 21 months, this child was bitten just below the right eye by a mosquito. The insect was brushed away. Swelling at the site of the bite began within 1 hour

DISCUSSION

The large local reactions to mosquito bites that we have designated as skeeter syndrome occur within hours of the bites and are characterized by the cardinal signs of inflammation: swelling (tumor), heat (calor), redness (rubor), and itching/pain (dolor). By inspection and palpation, it is impossible to differentiate between inflammation caused by infection and inflammation caused by an allergic response. Because most mosquito bites are unwitnessed and painless, the exact time interval between

Acknowledgements

We thank Dr Liping Cheng for technical assistance and the parents of the children with skeeter syndrome for their careful observations and timely photographs, which convinced us of the relationship between mosquito bites and these large local reactions.

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Supported by the Children’s Hospital Foundation, Winnipeg, Manitoba, Canada (operating grant and personnel awards to Drs Simons and Peng).

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Reprint requests: F. Estelle R. Simons, MD, FRCPC, Children’s Hospital of Winnipeg, 820 Sherbrook St, Winnipeg, Manitoba, Canada R3A 1R9.

J Allergy Clin Immunol 1999;104:705-7.

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