Table 1 Classification of systemic sting reactions (after H. L. Mueller [16], modified by U. R. Mueller [4])

I

Generalised urticaria, itching, malaise, anxiety

II

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

III

Any 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, feeling of impending disaster

IV

Any of the above plus two or more of the following: fall in blood pressure, collapse, loss of consciousness, incontinence (urine, stool), cyanosis