Fatal infection after a bee sting.
Life-threatening or even fatal bee infections can rarely develop after bee stings.
Aged↗
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Sudden death due to stinging insect hypersensitivity: postmortem demonstration of IgE antivenom antibodies in a fatal case.
This case report of a documented, witnessed death from an anaphylactic reaction to a single yellow jacket sting confirms the ability to demonstrate specific IgE antivenom antibodies in postmortem blood specimens. Implications and potential clinical impact are briefly discussed.
Adult↗
Corneal honeybee sting.
PURPOSE: To report a rare case of corneal honeybee sting. METHODS: The corneal honeybee stinger was removed under slit-lamp guidance using a 27-gauge needle. RESULTS: Corneal edema resolved by 90% the next day after removal of the honeybee stinger without using topical steroids. CONCLUSION: The patient's condition improved significantly after removal of the corneal honeybee stinger, and corneal edema disappeared. The patient was evaluated in 1 week and then 3 months with permanent mild central corneal opacity.
Adult↗
Multiple stings by imported fire ants (Solenopsis invicta), without systemic effects.
This is the first case report of imported fire ants invading a building and aggressively attacking a human being, resulting in multiple stings. This case illustrates that, although the venom has a high LD50 in mice, it does not induce toxic systemic effects in humans when the venom is introduced intradermally.
Aged↗
Catfish stings in Mississippi.
We reviewed a series of 83 catfish sting cases from inland hospitals (Belzoni and Indianola) and a coastal hospital (Pascagoula) to identify the type and severity of injury, as well as the type of treatment and its effectiveness. Oral cephalosporin was adequate in treating early infections.
Animals↗
Sting of the puss caterpillar: an unusual cause of acute abdominal pain.
We report the case of a 41-year-old man with abdominal pain after envenomization by a puss caterpillar. The patient's medical history and physical examination revealed classic symptoms, leading to the correct diagnosis and appropriate therapy with intravenous calcium gluconate. Although severe, local reactions to puss caterpillar envenomization have been previously described, to our knowledge this is the first report of a patient with severe, acute abdominal pain caused by a puss caterpillar's sting.
Abdominal Pain↗
Atopic disease, rhinitis and conjunctivitis, upper respiratory tract infections, and insect stings and snake bites.
In this section we review four broad topics in pediatrics: atopic disease, rhinitis and conjunctivitis, upper respiratory tract infections, and insect stings and snake bites. The first three topics comprise three of the most commonly encountered problems in pediatric practice. Although the fourth topic accounts for a relatively small number of office visits, it generates a great deal of concern among our patients and their parents. There have been significant contributions to the pediatric literature in each of these areas over the past year and we review those of particular interest.
Bites and Stings↗
Atopic disease, rhinitis and conjunctivitis, upper respiratory tract infections, and insect stings and snake bites.
In this section we review four broad topics in pediatrics: atopic disease, rhinitis and conjunctivitis, upper respiratory tract infections, and insect stings and snake bites. The first three topics comprise three of the most commonly encountered problems in pediatric practice. Although the fourth topic accounts for a relatively small number of office visits, it generates a great deal of concern among our patients and their parents. There have been significant contributions to the pediatric literature in each of these areas over the past year and we review those of particular interest here. The papers that we have chosen to review were selected for both their scientific significance and practicality. Both review articles and original research are included, but all should be relevant to the care of your patients.
Adolescent↗
Assessment and initial treatment of lacerations, mammalian bites, and insect stings.
Millions of wounds are seen in emergency rooms across the United States each year. The goals of wound care for all ages are to avoid infection and achieve an esthetically pleasing and functional scar. This article reviews the care needs associated with acute traumatic wounds. Information presented includes anatomy and physiology of skin and wound healing, and assessment and care of lacerations, bites, and sting wounds.
Animals↗
Genomic analysis in the sting-2 quantitative trait locus for defensive behavior in the honey bee, Apis mellifera.
We have sequenced an 81-kb genomic region from the honey bee, Apis mellifera, associated with a quantitative trait locus (QTL) sting-2 for aggressive behavior. This sequence represents the first extensive study of the honey-bee genome structure encompassing putative genes in a QTL for a behavioral trait. Expression of 13 putative genes, as well as two transcripts that were present in a honey-bee EST database, was confirmed through reverse transcription analysis of mRNA from the honey-bee head. Whereas most transcripts exhibited little or no variation between European and Africanized honey-bee alleles, one transcript demonstrated significant nonsynonymous substitutions, deletions, and insertions. All 13 putative genes lacked similarity to known invertebrate or vertebrate proteins or transcripts. This observation may be reflective of the processes that determine the genomic evolution of an insect with social behavior and/or haplo-diploidy and are an indication of the unique nature of the honey-bee genome. These results make this sequence an invaluable research tool for the ongoing honey-bee whole-genome sequencing effort.
Animals↗
On the significance of severe local reactions to Hymenoptera stings.
Of 317 patients with hypersensitivity to Hymenoptera stings forty had severe local reactions (SLR) only, fifty-nine reported severe local reactions before their first and seven after their last systemic reaction (SR). The probability to develop a life threatening systemic reaction when restung after a severe local reaction was calculated to be about 5%. In 80% of the patients with severe local reactions only, hypersensitivity to either bee or yellow jacket venom could be demonstrated by skin tests and/or RAST. A fair correlation of skin test and RAST results was observed. In patients with severe local reactions hyposensitization therapy with venoms is not generally indicated. In exceptional patients whose allergy is proven by skin tests or RAST and who are at a high risk of being restung, hyposensitization may be considered.
Adolescent↗
Low specific IgE, IgG and lymphocyte reactivity in a group of patients developing anaphylaxis following a honey-bee sting.
Ten patients who developed severe generalized reactions following a honey-bee sting were investigated for the presence of specific IgE and IgG antibodies, and for lymphocyte reactivity following in-vitro honey-bee venom (HBV) stimulation. Five of the patients (high responders) showed high HBV-specific IgE and IgG levels, whereas the other five patients (low responders) showed low HBV-specific IgE and IgG levels. Mononuclear cells from the high responder group incorporated significant amounts of 3H-thymidine when activated with pure bee venom, whereas insignificant lymphocyte proliferation was observed in the low-responder group. It is concluded that, amongst HBV-sensitive patients, a group of low responders exists in whom the mechanism of anaphylaxis cannot be explained.
Adolescent↗
Topical aluminum sulfate for fire ant stings.
Topical aluminum sulfate was not effective in relieving pain and stinging from the imported fire ant, contrary to a previous uncontrolled study.
Administration, Topical↗
Immunotherapy in bee sting hypersensitivity. Bee venom versus wholebody extract.
Fifty-six patients with serologically confirmed bee sting hypersensitivity were treated for 1-3 years with either bee venom (BV) (31 patients) or wholebody extract (WBE) (25 per cent of re-exposed patients on BV-therapy showed a diminished reaction and 75% no reaction. Thirty-three per cent of re-exposed patients on WBE-therapy developed an unchanged or worse reaction, 42% a diminished reaction and 25% no reaction at all. An initial rise in BV-specific IgE was observed in BV-treated patients, whereas IgE levels after 1 year of treatment lay significantly below pretreatment values in both treatment groups. BV-specific IgG increased markedly in patients on BV-therapy and decreased slightly in those on WBE-therapy. The initial IgE increase induced by BV-therapy was insignificant in patients with high pretreatment levels of specific IgG-antibodies. Similarly, re-exposed patients with high BV-specific IgG showed no IgE increase, whereas a substantial rise in specific IgE was observed in those with low IgG. On the basis of clinical and serological results immunotherapy with BV is considered to be clearly superior to immunotherpy with WBE.
Adult↗
Modified basophil degranulation test in diagnosis of bee and wasp sting allergies.
A modified basophil degranulation test proved reliable and easily reproducible in the investigation of 50 patients with allergies to bee and/or wasp stings. Its diagnostic value is comparable to that of the RAST and it is, in addition, simpler, quicker and cheaper. Its disadvantage is that it has to be performed within 24-36 hours after withdrawal of blood.
Adolescent↗
Phytophotodermatitis: differentiation from jellyfish stings.
A patient with phytophotodermatitis secondary to topical application of lime juice for relief of pain from a recent marine sting is reported. The absence of pain over the entire lesion and the failure of the patient to develop immune specific antibodies to common local coelenterates aided in establishing the diagnosis.
Adult↗
Multiple hornet (Vespa orientalis) stings with fatal outcome in a child.
A case of multiple hornet stings is described with a rapidly fatal course due to the combination of massive haemolysis, coagulopathy, rhabdomyolysis, hyperkalaemia, acute renal failure, encephalopathy, hepatotoxicity and hyperglycaemia. These features of systemic envenomation can all be attributed to the toxic properties of Oriental hornet venom described in in vitro and in vivo experimental studies. Greater awareness of these features, aggressive treatment of hyperkalaemia and early institution of treatments such as peritoneal dialysis and plasma exchange may prevent fatalities in such cases.
Acute Kidney Injury↗
Underrecognition of morbidity from stings of the red imported fire ant in the southeastern United States.
This cross-sectional study was conducted to determine the health-seeking behaviors of a group of patients stung by red imported fire ants (RIFA) and the number of nursing referrals resulting in treatment. The following two research questions were asked: (1) Is there a delay in seeking the care of a board-certified allergist for symptoms of fire ant hypersensitivity? (2) Are nurses referring patients for treatment? The entire population of board-certified allergists in Alabama, Georgia, and South Carolina (n = 98) was sampled. A questionnaire was developed for the office nurses to use to collect information from allergy patients actually receiving fire ant injections (n = 257). Each patient reported on the reaction, when it occurred as well as age, sex, and county of residence. Descriptive statistics revealed that a delay of a month or more in seeking care of an allergist was experienced by 154 (56%) of patients who completed the questionnaire. The average delay was 1.8 years. The main source of referrals was a general practitioner or emergency room personnel. Nursing and other health professionals must recognize the problem and to institute prompt referral for treatment. In areas where RIFA colonies are spreading, they have to be fully informed and trained in effective primary and secondary techniques to prevent serious reaction to the stings of these ants.
Adolescent↗