Clinical examination alone cannot distinguish between a response caused by
infection, such as
cellulitis, and skeeter syndrome. However, skeeter syndrome usually progresses over the course of hours versus cellulitis, which typically evolves over the course of several days. As such, accurate history is imperative when making the diagnosis. Since
IgE and
IgG are key players in mosquito allergy,
diagnosis can be confirmed by an immunosorbent
assay measuring IgE and IgG to mosquito saliva antigens.
Differential diagnosis Skeeter syndrome should not be confused with another type of reactivity to mosquito bites,
severe mosquito bite allergy (SMBA). SMBA is most often an
Epstein-Barr virus-associated lymphoproliferative disease that complicates ~33% of individuals with
chronic active Epstein-Barr virus infection or, in extremely rare cases, individuals with Epstein-Barr virus-positive
Hodgkin disease or an Epstein-Barr virus-negative lymphoid disease such as
chronic lymphocytic leukemia and
mantle cell lymphoma. It is a
hypersensitivity reaction characterized by the rapid development of skin redness, swelling, ulcers,
necrosis and scarring following mosquito bites. The reaction is often accompanied by relatively severe systemic symptoms such as fever and
malaise; enlarged lymph nodes, liver, and/or spleen; liver dysfunction; hematuria; and proteinuria. ==Treatment==