Mild Hemifacial Assymetry Caused by a Single Bee Sting

Abstract

Multiple stings can cause multiple local and systemic effects. The various allergic reactions can range from local edema and erythema to anaphylactic shock and death. Acute renal failure, nephrotic syndrome, and heart and liver toxicity are among the multiple systemic effects of the insect venom [3,6–10]. Venom is a complex mixture of many substances, such as toxins, enzymes, growth factor activators, and inhibitors, that are responsible for the deleterious effects on cells [5]. Envenomation involves activation of the inflammatory response, with the release and activation of proinflammatory cytokines and other mediators, such as nitric oxide. These constituents interact in the body with a large number of proteins and receptors, and this interaction determines the eventual inflammatory effect of the compounds. Cytokines are important for the interactions between cells in the immune and inflammatory responses. Although the pathophysiology of envenomation is not fully understood, venom and immune responses are known to trigger the release of cytokines and nitric oxide. Local hypersensitivity reactions after bee stings are very common and well studied. Local skin reactions after bee stings may result in severe complications such as tissue necrosis if left untreated [4]. Venom therapy also is reported to induce panniculitis [2].