Abstract
Attacks by swarm of bees realize arrays of mass poisoning. We report the case of a 9 years old boy whoes severity was related to the large number of bees which was about 400 and their locations spread throughout the skin surface with a preponderance to the cephalic end. Complications were hemolytic anemia, kidney failure and convulsions. The outcome was favorable with symptomatic care and hemodialysis.
Highlights
Attacks by swarm of bees realize arrays of mass poisoning
We report the case of 9 years old boy who survived after a massive envenomation complicated of renal failure
The mellitin, bees specific, is the main component of the venom (50%) and is responsible for inflammatory reaction, cytolysis, intravascular hemolysis and rhabdomyolysis that can complicate and lead to kidney disease
Summary
It is the case of 9 years old boy with no notable medical history, admitted an hour after an attack by a swarm of bees during mangoes gathering. The blood pressure was 120/60 mm Hg [normal range below 130/80 mm Hg] He received a paracetamol-based analgesic of 15 mg/kg dose combined with 20 mg of nefopam every 6 hours, a vascular filling with isotonic saline serum of 20 ml/kg dose. Laboratory tests revealed an hyperuremia 1.68 g/l [0.10 - 0.40 g/l], an elevated serum creatinine concentrations at 50 mg/l [4 - 6 mg/l], a severe anemia at 6 g/dl [12 - 14.5 g/dl], an hyperleukocytosis at 12,300/mm3 [4500 - 11000/mm3] of neutrophilic 7600/mm3 [2000 6000/mm3] predominant and eosinophils 861/mm3 [100 - 400/mm3], a thrombocytopenia 78000/mm3 [150000 - 400000/mm3], an accelerated erythrocyte sedimentation rate at 74 mm in the first hour [normal range below 20 mm]. He has been discharged on 24th day and keeps a ptosis sequel left
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