Skeeter syndrome

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 and was accompanied by redness and warmth. The eye rapidly swelled shut and remained swollen for a week. Blood culture was negative. Later, during the summer, similar reactions occurred after mosquito bites on the lower leg and the ear. The photograph was taken by the child’s mother.

A, Significantly elevated serum concentrations of A vexans saliva–specific IgE, IgG1, IgG3, and IgG4 were found in children with skeeter syndrome (mosquito bite–induced large local inflammatory reaction originally diagnosed as cellulitis) in contrast to age-matched control children. IgG2 was not detectable. B, Seasonal variation in A vexans saliva–specific IgE, IgG1, IgG3, and IgG4 in children with skeeter syndrome. Antibody concentrations declined significantly during the cold winter months when no exposure to mosquitoes occurred.