Thank you for your inquiry.
Unfortunately I cannot give you a definite answer to your question. In my opinion, if you asked multiple allergists-immunologists this question, you would get different answers. Certainly, there is little in this patient’s history to suggest a bona fide anaphylactic reaction, but now that he has been tested and has shown multiple positive reactions, we are left with a clinical decision which is colored not only by the medical facts but also by medicolegal issues. All in all, the answer is going to be solely dependent upon the clinical judgment of the physician in charge of his therapy.
I probably would initiate venom immunotherapy in this case, but I would certainly not argue with the opposite decision.
Thank you again for your inquiry and we hope this response is helpful to you.
Phil Lieberman, M.D.