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PubMed1986

Arthropod bites, stings, and infestations: their prevention and treatment.

Readily available information as to the management of arthropod bites, stings, and infestations is important to have but often difficult to find. This article brings such information together in one reference for use by the practicing pediatrician, dermatologist, and family practitioner. Preventive measures are stressed and therapy is outlined for each entity; the rationale for many of the interventions is discussed. It is not the intent of this paper to cover each subject comprehensively.

Arachnida↗
PubMed2006

Acute myocardial infarction in a young man caused by centipede sting.

It is known that insects can cause various clinical effects such as myocardial ischaemia and hypotension from vasospasm and the myocardial toxic effects of the venom and anaphylaxis. Although myocardial ischaemia resulting from centipede sting has been reported once before, myocardial injury has not. In this report, the authors present the case of a 20 year old male patient bitten by a centipede and admitted to the emergency room with chest pain, abnormal electrocardiographic findings, and increased cardiac enzymes (cardiac troponin T) suggesting acute myocardial infarction.

Adult↗
PubMed1999

Nephrotic syndrome with mesangial proliferative glomerulonephritis induced by multiple wasp stings.

We report the case of a young male who developed severe nephrotic syndrome within 2-3 weeks after being stung by 3 wasps. A percutaneous kidney biopsy specimen revealed mesangioproliferative glomerulonephritis with occasional subepithelial deposits suggestive of early membranous nephropathy. The patient was treated with oral prednisone 60 mg/day with no significant clinical response after 4 weeks, at which point he was started on oral cyclophosphamide, 100 mg/day, while the prednisone dose was tapered to 20 mg every other day over a 2-week period. Six months after initiation of cyclophosphamide, he still has severe nephrotic syndrome. We also briefly review the literature on Hymenoptera sting associated nephrotic syndrome.

Adult↗
PubMed2000

Structure and biology of stinging insect venom allergens.

Bees, fire ants and vespids cause insect sting allergy. These insects have unique as well as common venom allergens. Vespids, including hornets, paper wasps and yellow jackets, have common allergens. Bees and vespids have one common allergen with hyaluronidase activity; they also have unique allergens with different phospholipase activities. Fire ants and vespids have one common allergen, antigen 5 of unknown biologic activity. The common venom allergens with < 70% sequence identity have barely detectable levels of antigenic cross-reactivity. Possible uses of modified allergens for immunotherapy are described.

Allergens↗
PubMed1986

Transient cerebral ischemic attack caused by Hymenoptera stings: the brain as an anaphylactic shock organ.

Forty-two patients with severe hypersensitive reactions caused by Hymenoptera (bees and wasps) sting(s) were studied clinically. Central nervous systemic reactions were observed in 30 out of 42 patients (71.5%); they occurred in 20 patients (47.5%) with hypersensitive cardiovascular damage and in 10 patients (23.8%) without cardiovascular symptoms. A considerable part of these hypersensitive reactions in the central nervous system may be considered as typical signs and symptoms of the transient cerebral ischemic attack (TIA). The clinical findings provide strong evidence that the brain is a frequented anaphylactic shock organ and many anaphylactic reactions of the central nervous system might be regarded as a specific form of TIA.

Adolescent↗
PubMed1989

Relationship of serum venom-specific IgE titers to clinical aspects of stinging insect allergy.

Fifty patients were randomly selected who had markedly elevated titers of serum venom-specific IgE (range 100-340 IU, mean 144 IU), and compared with 50 patients with low titers (range 0-50 IU, mean 25 IU). At the time serum was obtained, none of the patients had received venom immunotherapy (VIT). Analysis of the demographic data showed more children in the high-RAST group, and comparable matching of the groups for sex, presence of atopy, and culprit insect identification. The nature of the reaction preceding evaluation was similar in both groups. In the high-RAST group, there were 12 local, 15 mild systemic, and 23 severe systemic reactions. In the low-RAST group, there were 8 local, 15 mild systemic, and 27 severe systemic reactions. Other prior local reactions had occurred in 4 high-RAST and 4 low-RAST patients, and other prior systemic reactions had occurred in 3 high-RAST and 8 low-RAST patients. The incidence of systemic and local reactions following VIT was low in both groups. All but 1 patient in each group reached maintenance venom doses. Following initiation of VIT, 10 of 28 patients in the high-RAST group and 5 of 29 patients in the low-RAST group had a further rise in antibody titers. Patients in both groups showed a decrease in titers over a period of time, with or without VIT. Serum venom-specific IgG was greater in the high-RAST group (mean 9.4 U) than in the low-RAST group (mean 3.8 U). The absolute titers of serum venom-specific IgE appear unrelated to any specific feature of stinging insect sensitivity.

Adolescent↗
PubMed1985

Season dermatitis ex insectis caused by stings of Sclerodermus domesticus.

Case history of five members from the same family is reported. They developed papulourticarial pruritic rash on the skin of their torsos and extremities during their summer stay in an old family house. The cause was an insect determined as Sclerodermus domesticus, known for its parasitism on larvae of a wood pest. Examination of the furniture revealed a lot of holes typical for these pests. Cases of stings of these insects have not been described in Yugoslavia till now.

Animals↗
PubMedDate not supplied

Acute myocardial infarction after a European hornet sting--a case report.

The authors briefly describe an 87-year-old man who experienced an acute ST-elevation myocardial infarction in the context of an anaphylactic reaction caused by a European hornet (Vespa cabro linnaeus) envenomation. This unusual case highlights the potential cardiovascular complications associated with common insect stings such as those caused by hymenoptera. Thus, a thorough cardiovascular evaluation is essential in such cases since the vasoactive, inflammatory, and thrombogenic mediators of anaphylactic reactions may provoke myocardial ischemia.

Aged, 80 and over↗
PubMed2003

Severe cardiac failure associated with presumed jellyfish sting. Irukandji syndrome?

We present a retrospective review of twelve cases of Irukandji syndrome associated with pulmonary oedema. This is a life-threatening envenoming due to a presumed jellyfish sting throughout Northern Australia, although only one case occurred outside North Queensland. Patients presented with significant and ongoing pain, tachycardia and hypertension. Half the patients became hypotensive requiring inotropic support. Cardiac echocardiography revealed significant cardiac dysfunction. Six patients required ventilatory support. There was no death reported due to pulmonary oedema, but one patient died of intracerebral haemorrhage. We believe patients may develop a toxin associated cardiomyopathy, and jellyfish other than Carukia barnesi may be responsible. As there is confusion with nomenclature, Carukia barnesi should be known as the Barnes jellyfish, and the diagnosis of cardiotoxic marine envenoming is suggested for any patient who has been stung by a jellyfish, develops no or minimal skin markings, and develops cardiogenic pulmonary oedema associated with Irukandji syndrome.

Adolescent↗
PubMed2001

Fatal weeverfish sting.

We report a case of fatal weeverfish sting. An 18-year-old man was stung on the left leg by a weeverfish, which he was attempting to capture while snorkelling off the coast of Majorca (Spain). The man felt intense pain, but managed to swim to his boat where he lost consciousness after boarding rapidly. An hour later, when examined by a doctor, the subject was found to be in cardiorespiratory arrest. Reanimation manoeuvres were unsuccessful. The most import post-mortem findings were in the skin and lungs. A puncture wound, which traversed the greater saphenous vein and was covered by an intense haemorrhagic infiltrate, was observed in the skin. The lungs showed haemorrhagic alveolar oedema.

Adolescent↗
PubMed1989

Pulmonary infiltration with blood eosinophilia after scorpion sting.

A 30-year-old man developed bilateral pulmonary infiltrates with blood eosinophilia after receiving a scorpion sting. A short course of corticosteroids resulted in rapid improvement. The PIE syndrome after scorpiasis has not, to our knowledge, been described previously.

Adult↗
PubMed1980

Intraoral Hymenoptera sting.

Four days before a routine dental examination, the patient had been stung on the left side of the soft palate by a yellow jacket. The lesion was well demarcated, with a prominent area of deep red erythema approximately 1.5 cm in diameter. inside of which was a coral pink ring approximately 0.5 cm in diameter. The patient was not experiencing discomfort at the time of examination. Reactions to Hymenoptera stings usually include pain, erythema, and swelling, but, in more severe instances, extensive swelling and systemic reactions in the form of anaphylaxis or delayed allergic responses may be seen. The patient should be referred immediately to a physician or medical treatment facility for observation and treatment if necessary. If the stinger is located either periorally or intraorally, it should be carefully removed by flicking so that additional venom from the sac is not injected into the patient.

Adult↗
PubMedDate not supplied

Prevalence of allergy to Hymenoptera stings.

In this study, we evaluated the prevalence of systemic reactions to hymenoptera stings in an adult general population, 20-60 years old. The protocol included a standardized questionnaire, skin tests to venom in subjects reporting a history of systemic reaction, and in subjects reporting a history of severe local and systemic reactions, as well as in a control group, a radioallergosorbent test (RAST) to hymenoptera venoms. According to the questionnaire, 1.2% of the study population had a history of systemic reactions. Only 0.85% had both such a history and a positive skin test to venoms. RASTs were positive, for at least one venom, in 57% of subjects with a history of systemic reaction, 15.8% of subjects with a history of severe local reactions, and 6.0% of the control group. In conclusion, this study shows that systemic reactions are not uncommon in the general population. RASTs tests are not sensitive or specific enough to be considered, per se, for indications of allergy to venoms.

Adult↗
PubMed1995

Fatal multiple organ failure following massive hornet stings.

We describe a fatal outcome in a three-year-old child following massive stings by the oriental hornet (Vespa orientalis). The primary clinical features were coma, respiratory failure, coagulopathy, renal failure and liver dysfunction. On postmortem the main organs involved were brain, lungs, kidney and liver.

Animals↗
PubMed2005

Managing insect sting allergy. The ins and outs of venom immunotherapy.

Insect sting allergy can lead to severe, even fatal, reactions in susceptible persons. Although self-injection epinephrine often terminates the reaction, it is not always effective. In this article, Dr Graft explores the use of venom immunotherapy (VIT) in selected patients in whom successful treatment can produce psychosocial as well as physiologic benefits.

Adolescent↗
PubMed2003

Acute myocardial infarction in a professional diver after jellyfish sting.

To our knowledge, acute myocardial infarction after jellyfish envenomation has not been reported previously. We describe a previously healthy 45-year-old male diver who had an acute inferior myocardial infarction with right ventricular involvement after a jellyfish sting on his left forearm while diving in the Gulf Sea. The patient had a normal controlled ascent after the incident. He had no risk factors for coronary artery disease, and cardiac catheterization revealed normal coronary arteries. Acute myocardial infarction should be considered in patients who experience chest pain or have hemodynamic compromise after jellyfish envenomation.

Animals↗