Severe allergic reaction to diethyltoluamide (DEET) containing insect repellent
Bibliographic record
Abstract
Contact and generalized urticaria to DEET-containing repellents have been reported, but few cases of severe allergic reaction with angioedema. A 53 year-old female bridge inspector presented with allergic reaction to diethyltoluamide (DEET) - containing insect repellent. She had prior use without difficulty. In 2013, she used the insect repellent and with only a small amount making contact with her forehead, she had immediate pruritus and erythema on her forehead, persisting for an hour. The following week, she used a different insect repellent and sprayed her face and body. Within minutes, she became diffusely pruritic with generalized urticaria and angioedema of her eyes. She called 911 and was given intramuscular diphenhydramine. Her symptoms gradually eased and she was subsequently well. Her regular medications include venlafaxine and ketorolac. She has no history of atopy. Since the reaction, she has been avoiding all forms of insect repellent, including riding in separate vehicles as her co-workers who use insect repellent. She carries an epinephrine device at all times. Skin testing was performed using two DEET-containing insect repellents: Lloyd’s Bug Spray (23.75% DEET) and OFF Family Care Bug Spray (5% DEET). She had positive skin prick test to both insect repellents, more prominent with the higher containing DEET repellent. There was also a significant reaction on the skin adjacent to the test site where the repellent had not made contact. She developed significant pruritus and was treated with oral anti-histamine. She had appropriate controls. A control subject tested in the office was negative to both insect repellents. The patient had a severe allergic reaction to insect repellent, and exhibits sensitization based on skin testing. This represents a unique case of severe cutaneous reaction to insect repellent and such patients may be at risk of anaphylaxis with future exposure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".