Late asthmatic reactions due to larvae of Calliphora erythrocephala used as fishing bait

Clinical characteristics of allergic asthma due to inhalation of insect antigens have been investigated very little. We describe two patients presenting with dyspnoea and wheezing several hours after exposure to larvae of Calliphora erythrocephala used as fishing bait. Both patients had a positive intradermal skin test and a high level of circulating IgE to the specific allergen. Bronchial challenge test with the whole larvae resulted in an isolated late response in one case, and in a dual response in the other, which were prevented by premedication with DSCG or beclometazone. The occurrence of late asthmatic reactions may render it difficult for the identification of insect antigens as the causal agent of extrinsic allergic asthma.