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Several allergic conditions sit outside the usual respiratory or skin categories. Latex allergy can affect anyone exposed to medical gloves and certain foods through cross-reactivity. Drug allergies include penicillin and other antibiotic reactions. Insect sting allergy covers bees, wasps, and fire ants common in Texas. Multiple chemical sensitivity is a controversial diagnosis with overlap to allergic disease. We treat all of these as part of our routine practice.

Often, yes. About 90 percent of people who carry a penicillin allergy label are not actually allergic when tested. Reactions in childhood that may have been viral, fading family memory, or mild rashes that resolved often produce a label that sticks for life and limits antibiotic options. Our office runs penicillin de-labeling testing in a single afternoon visit. Take the penicillin de-labeling assessment to see if you are a candidate, and read more in our drug allergy resource.

Yes, it is real and well documented. Exercise-induced anaphylaxis is a rare condition where vigorous exercise triggers a severe allergic reaction, sometimes only when combined with a specific food eaten beforehand (most commonly wheat, shellfish, or celery). Symptoms include hives, swelling, and breathing difficulty during or shortly after exercise. Patients carry epinephrine and modify their food and exercise patterns. We treat this condition at our practice. Read our coverage of anaphylaxis for broader context.

Stings from bees, wasps, hornets, and fire ants are common in Texas and most reactions are local and resolve in hours. About 1 to 2 percent of the population has systemic allergic reactions that can include anaphylaxis. Patients with prior systemic reactions need an EpiPen, an action plan, and possibly venom immunotherapy, which is highly effective at preventing future severe reactions. The insect sting allergy guide and our stinging insect resource cover this in depth.

The asp caterpillar (puss caterpillar) is one of the most painful stings in Texas, and severe systemic reactions are possible though rare. Late summer through fall is peak season, especially on oak and hackberry trees. First aid involves removing spines with adhesive tape, cool compresses, and oral antihistamines. Our article on asp caterpillar stings covers identification, first aid, and when to seek emergency care. Severe reactions warrant an allergist evaluation and possible epinephrine prescription.