Death of a child due to venom toxicity following multiple honey bee stings: A case report

Abstract

Most bee stings are not life-threatening. Bee venom often causes local, mild allergic reactions in people, but even a single bee sting may induce a fatal anaphylactic reaction. Usually, anaphylactic reaction is the cause of death, but, when a child suffers multiple stings (more than 30), direct toxicity of venom can also be fatal. A three-year-old male child was brought to the hospital with pain, swelling and redness at the sting sites. He had more than 35 stings at various sites over his face, on his tongue and over his body. He died 10 hours after the incidence of the honey bee stings and was maintaining oxygen saturation until the terminal stage of his life. At autopsy, the honey bee sting sites showed redness, swelling and a small effusion of blood surrounding the stinger tracks. On the tongue two stingers were found in situ. Facial puffiness and eyelid swelling, along with congested organs, were also found, but features suggestive of anaphylactic death like airway oedema, mucous plug or cyanosis were absent. Hospital treatment records show that blood pressure remained low with tachycardia despite treatment. Having regard for all the evidence it was concluded that death was due to multiple honey bee stings that caused direct venom toxicity.