Bee Sting Research Articles

Removal of soft tissue foreign bodies in the hand under microscopy: a retrospective observational study

Purpose: Numerous studies have focused on techniques for detecting foreign bodies in soft tissue in the hand, but removal remains a subject of interest. In this study, we describe the microscope-assisted removal of foreign bodies in the hand. Methods: We reviewed records of patients treated for foreign bodies in the hand at our department from July 2013 to May 2023. In 16 patients aged 23 to 55 years, the following variables were analyzed: the cause of trauma; the time interval from trauma to surgery; the location, type, size, and number of foreign bodies; patient complaints; imaging technique; and procedure type. Under local anesthesia, a slit incision was made at the suspected site. Foreign bodies were completely removed using micro-instruments under microscopic guidance. Results: Stab injuries were the most common (n=13), and there was one case each of abrasion, traffic accident, and bee sting. The middle finger (n=5) was the most affected, followed by the thumb (n=4), index (n=3), little finger (n=2), ring finger (n=1), and palm (n=1). Foreign bodies included glass (n=6), wood (n=4), seashell (n=2), fish bone, a pencil tip, a bee stinger, and metal. Their size ranged from 1 to 20 mm. Patient complaints included a foreign body sensation, localized pain, swelling, discoloration, and a skin lesion. X-ray examinations were performed in all cases, and ultrasonography was conducted in five cases. Conclusion: A microscopic approach allows precise, safe, and complete removal of foreign bodies without tissue damage, highlighting the efficacy of this technique in hand surgery.

A prediction nomogram for mortality in patients following wasp stings: a retrospective study

Numerous studies have shown that wasp stings can lead to serious, sometimes fatal, health outcomes. Predicting deaths associated with wasp stings remains challenging yet is of critical importance. This study was conducted to identify predictors and develop a visual model for predicting mortality following wasp stings. Clinical data from 486 patients were analyzed, dividing them into two groups: survival group (N = 435) and death group (N = 51). Various statistical methods were used to create a prognostic model, including one-way analysis, the least absolute shrinkage and selection operator (LASSO) regression, and binary logistic regression. The model’s accuracy was evaluated through ROC curves, calibration plots, and decision curve analysis (DCA). The study identified four key predictors of mortality: receiving more than 50 stings, having serum lactate dehydrogenase (LDH) levels of ≥ 2200 U/L, activated partial thromboplastin time (APTT) of ≥ 90 s, and the requirement for invasive mechanical ventilation within 24 h. These factors contributed to a model with an area under the ROC curve of 0.980 (95% CI: [0.968–0.992]), indicating high calibration and applicability. The decision curve analysis confirmed the model’s substantial net clinical benefit. Thus, the number of stings, serum LDH, APTT, and the need for early invasive mechanical ventilation are reliable, independent predictors of death among patients experiencing wasp stings. The developed predictive model exhibits high levels of accuracy, sensitivity, consistency, and practical use.

Efficacy of Arkadi Agada Lepa in Honey Bee Sting in Albino Mice

In Samhita Granthas many Keetas are explained, some of them are never heard before. Today not only their existence but also their availability is difficult. Due to honey bee sting patient initially complaints of pain, swelling, redness of skin around sting. Severe side effects as nausea, fainting & in extreme cases patient may get die due to anaphylactic shock. According to Ashtang Hruday Uttarsthan for all type of kita visha Arkadi Agad is beneficial. Honey Bee is included in kita visha .considering the importance of local application (lepa) in all types of poisoning. Arkadi Agad Lepa selected to study its effectiveness in honey bee sting in Albino Mice.

Ocular bee sting injury: case report

Introduction: Eye accidents caused by bee stings are uncommon and little reported worldwide. There is still no protocol to be followed in these situations that need to be individualized. A case is reported of a bee sting remaining inside the lens of a middle-aged man that was surgically removed without phacoemulsification, which kept the patient's accommodation and good sight. Patient and Clinical Findings: A 41-year-old man presented with red left eye, low visual acuity, and pain after being stung by bees all over his body, including his left eye. There was a lot of inflammation and corneal edema that did not allow complete visualization. Diagnosis, Intervention, and Outcomes: After starting clinical treatment, it was possible to visualize the sting inside the patient's lens. Conservative surgery was proposed with the removal of the stinger keeping the patient's lens clear. After 6 months, he presented visual acuity with no correction of 0.1 logMAR in both eyes and J1 without high intraocular pressure, but corneal endothelial specular microscopy demonstrated significant endothelial loss such as a consequence poison of the sting. Conclusions: There is still a lack of cases in the literature that could assist in a protocol in cases of intraocular bee sting. What is known is that each patient must be individualized, and in this situation, it was possible to conduct the event while maintaining the lens and the patient's accommodation capacity.

Machine-learning based prediction model for acute kidney injury induced by multiple wasp stings

Acute kidney injury (AKI) following multiple wasp stings is a severe complication with potentially poor outcomes. Despite extensive research on AKI's risk factors, predictive models for wasp sting-related AKI are limited. This study aims to develop and validate a machine learning-based clinical prediction model for AKI in individuals with wasp stings. In this retrospective cohort study, conducted at a tertiary teaching hospital in Yichang, China, from July 2013 to April 2023, 214 patients with wasp sting injuries were analyzed. Using least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression, prognostic variables for AKI were identified. A nomogram incorporating these four variables was constructed. The model's performance was assessed through internal validation, leave-one-out cross-validation, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). Among 214 patients affected by wasp stings, 34.6% (74/214) developed AKI. Following LASSO regression and multivariate logistic regression, the number of stings, presence of gross hematuria, systemic inflammatory response index (SIRI), and platelet count were identified as prognostic factors. A nomogram was constructed and evaluated for its predictive accuracy, showing an area under the curve (AUC) of 0.757 (95% CI 0.711 to 0.804) and a concordance index (C-index) of 0.75. Validation confirmed the model's reliability and superior discrimination ability over existing models, as demonstrated by NRI, IDI, and DCA. The developed nomogram effectively predicts AKI risk in wasp sting patients, facilitating early identification and management of those at risk.

An Unusual Neurological Complication of Multiple Wasp Stings: AIDP

Background and Aims: Wasp stings often result in vascular problems and local irritation. Rarely neurological difficulties result from a delayed immune response, which causes acute inflammatory demyelinating polyradiculopathy, stroke and Parkinson’s disease. Patient’s Concern: Here we are describing a young male, who presented to us with ascending paralysis a few days after being stung by multiple wasps. The patient did not have any infection or recent vaccination. Nerve conduction velocity (NCV) suggested increased latencies in peripheral nerves. Hence, a temporality between Guillain–Barré syndrome (GBS) and the wasp sting was hypothesised. Intervention: After establishing a diagnosis, the patient received standard treatment for acute inflammatory demyelinating polyneuropathy (AIDP). Intravenous immunoglobulins were given over 5 days in divided doses. The patient had gross improvement in the weakness by day 7 and fully recovered in 2 months. Conclusion: This case study highlights the possibility of acute demyelinating polyradiculopathy, a serious neurological consequence that can arise from wasp stings. Nevertheless, the pathophysiology of the same is not well recognised in the literature. This emphasises the importance of identifying uncommon causes of GBS and comprehending the mechanism and curative measures.

Insect anaphylaxis

Anaphylaxis is a serious allergic reaction that is life-threatening. Insect anaphylaxis is diagnosed in one in 10 patients with anaphylaxis. Timely treatment and a clear algorithm of tactics to manage the condition can save the patient’s life. Diagnostics and properly selected recommendations will bring more understanding of the principles of exclusion of future reactions. This article presents data on the prevalence, clinical manifestations, diagnosis and treatment of patients with insect anaphylaxis. A clinical case of wasp sting anaphylaxis is also presented.

Severe Clinical Impact of Multiple Wasp Stings: A Case Report of Acute Kidney Injury

Wasp stings are prevalent in Indonesia and have occasionally resulted in fatalities. Wasp stings can potentially induce a small localized allergic response, systemic reactions, or even life-threatening illnesses. Receiving several stings from wasps can cause systemic inflammation, resulting in acute kidney injury. We present a case of a 51-year-old female who experienced severe renal impairment as a result of repeated wasp stings. Following the stings, the patient promptly obtained medical attention. However, on the second day after the incident, the patient's renal function declined and experienced anuria. The ultrasonography indicates the presence of nephritis. The patient presented with 103 sting wounds, which resulted in local reactions and were accompanied by systemic symptoms. The patient was administered high-dose steroids and underwent five intermittent hemodialysis sessions, which effectively restored their kidney function. Evidence of enhanced renal function was demonstrated through the restoration of normal urine production, elevated glomerular filtration rate, and significant clinical improvements in the patient. This case illustrates the severe impact on the kidney of a generalized wasp sting and the effect of promptly receiving medical treatment following an enormous wasp sting on the patient's prognosis. Initiating dialysis promptly is crucial for rapidly eliminating toxins and thus preserving renal function.

Wasp sting-induced rhabdomyolysis and acute liver injury in a young, healthy patient: An uncommon case.

Wasp stings represent a significant environmental hazard in Sri Lanka. While the majority of individuals experience only localized symptoms, a subset may exhibit allergic reactions of varying severity. In rare instances, these reactions can escalate to life-threatening complications. Rhabdomyolysis, a severe consequence of muscle injury induced by wasp venom, necessitates early diagnosis and prompt intervention to mitigate potential fatalities. We present the case of a 32-year-old male with no prior health issues who was admitted following multiple wasp stings. On the second day of admission, he developed rhabdomyolysis and hepatic injury. With appropriate fluid management, the patient made a full recovery. This case underscores the importance of timely intervention in managing the severe complications of wasp stings.

A Case of Massive Envenomation with Bee Sting: A Case Report

A Case of Massive Envenomation with Bee Sting: A Case Report

Bee Sting Injuries in Thailand's High Apicultural Area: Outcome, Risk and Treatment Patterns.

This study aims to assess the clinical outcomes and risk factors associated with severe systemic reactions following bee stings, focusing on patients treated at Pa-Sang Community Hospital, located in Lamphun Province, Thailand, which is recognized as one of the country's largest apicultural areas. A retrospective review was conducted, utilizing electronic medical records with ICD-10 coding, of patients treated for bee sting injuries at the Emergency Department of Pa-Sang Hospital from January 2015 to December 2019. This analysis included a total of 591 bee sting events involving 533 patients. The average incidence of bee sting injuries was 31.3 per 10,000 Emergency Department visits, with 55% being male. A significant majority (86%) of events occurred outside the patients' home area. Notably, the head or extremities (49%) were the most common anatomical sites stung. Systemic reactions were observed in 44% of cases, with 96 visits (16%) diagnosed as anaphylaxis. Epinephrine injection was administered in 77% of these cases, and fortunately, no fatal anaphylactic reactions were recorded. Protective factors for anaphylaxis and severe systemic reactions after bee stings included age less than 15 years old and stings on extremities. Conversely, having more than ten bee stings and seeking Emergency Department treatment within 60 minutes of being stung were identified as significant risk factors. Bee sting injuries were a common presentation at the hospital situated in the high apicultural area, and severe systemic reactions were observed. This study highlights the need for comprehensive interventions to mitigate the increased risk of bee-related accidents in communities with thriving apicultural industries.

Tale of a retained corneal bee sting

Tale of a retained corneal bee sting

Development of Cutaneous Pseudolymphoma following Bee Sting: A Case Report

Cutaneous pseudolymphoma (CPL) is a benign skin disorder characterized by the presence of a lymphocyte-rich infiltrate resembling malignant lymphoma. As there are significant differences in management and clinical outcomes, differentiating CPL from true lymphomas is crucial. The diagnostic process involves a comprehensive approach, incorporating clinical examination, histopathological analysis, and when necessary, immunohistochemical staining to distinguish CPL from true lymphomas. Biopsy plays a key role in assessing characteristics of infiltrating lymphocytes and architectural arrangements of cells within dermal layers. Here, we present an unusual case of CPL triggered by a bee sting, outlining its clinical and pathological features.

Renal and Hemorrhagic Complications Following Bee Sting Envenomation: A Case Report from the Hospital of Zinder

Renal and hemorrhagic complications following envenomation by bee stings are rare, posing significant problems for early diagnosis and treatment in the clinical setting. Bee venom is generally well tolerated. A 44-year-old patient was admitted to the infectious and tropical diseases department of the Zinder National Hospital with cervicofacial edema following bee stings. Initially, the patient lost consciousness. Respiratory symptoms included dyspnea and 91% desaturation on room air. The patient was put on oxygen to alleviate hypoxia, doxycycline to prevent secondary bacterial infections, and prednisone to reduce inflammation. The clinical picture was complicated by a worsening of the patient's condition due to a deterioration in renal function, and the subsequent appearance of hematemesis. A renal biopsy revealed acute tubulointerstitial nephropathy, due to direct venom toxicity on the tubules. He was discharged after 35 days. We report a rare case of bee sting complicated by hemorrhagic syndrome and renal involvement.

500 bee stings in a single fatal encounter.

Incidences of multiple bee stings have been increasing globally; the substantial amount of bee venom injected in such incidents can result in anaphylactic shock, rhabdomyolysis and renal failure, proving fatal in some cases. While anaphylactic reactions are more common and have established treatment protocols, inflammatory response induced by the venom demands a tailored approach. Here we report a case of a 70-year-old male in India who succumbed from approximately 500 bee stings. Based on our literature review, this case stands out as one of the first reported fatalities caused by 500 bee stings in our country. The unidentified species of bees in this case makes management of such bee venom-related toxic reactions more difficult. This report emphasises the importance of prompt and appropriate interventions.

Being Stung Once or Twice by Bees (Apis mellifera L.) Slightly Disturbed the Serum Metabolome of SD Rats to a Similar Extent.

In most cases, the number of honeybee stings received by the body is generally small, but honeybee stings can still cause serious allergic reactions. This study fully simulated bee stings under natural conditions and used 1H Nuclear Magnetic Resonance (1H NMR) to analyze the changes in the serum metabolome of Sprague-Dawley (SD) rats stung once or twice by honeybees to verify the impact of this mild sting on the body and its underlying mechanism. The differentially abundant metabolites between the blank control rats and the rats stung by honeybees included four amino acids (aspartate, glutamate, glutamine, and valine) and four organic acids (ascorbic acid, lactate, malate, and pyruvate). There was no separation between the sting groups, indicating that the impact of stinging once or twice on the serum metabolome was similar. Using the Principal Component Discriminant Analysis ( PCA-DA) and Variable Importance in Projection (VIP) methods, glucose, lactate, and pyruvate were identified to help distinguish between sting groups and non-sting groups. Metabolic pathway analysis revealed that four metabolic pathways, namely, the tricarboxylic acid cycle, pyruvate metabolism, glutamate metabolism, and alanine, aspartate, and glutamate metabolism, were significantly affected by bee stings. The above results can provide a theoretical basis for future epidemiological studies of bee stings and medical treatment of patients stung by honeybees.

Facial nerve palsy following bee sting: a case report

One of the most common insect poisoning is bee sting. It can produce local symptoms such as pain, redness, and fever following a local pain. Rarely, anaphylaxis, myocardial infarction, organ failure, epilepsy and other neurological diseases have been reported. Lower motor neuron facial nerve palsy is one of the common diseases of the Otorhinolaryngology clinic. Although it is usually idiopathic, trauma and tumors are the two most common causes. Usually, it is diagnosed clinically and the grade of palsy is based on House Brackmann Classification. We present a case of left Bell’s palsy due to bee sting. A 21-year-old male patient was referred to our clinic for persistent incomplete eye closure for two weeks duration. Upon further history, he complained that prior to the left sided facial weakness he was stung by a bee the night before on his left toe and developed the facial weakness when he woke up in the morning. He did not get immediate treatment. Clinically he had Grade III left lower motor neuron facial nerve palsy. Other ear, nose and throat examinations were unremarkable. He was treated with oral steroid and eye care. One week upon follow up, his facial weakness was completely resolved.

Recent advance in neurological complications following wasp stings

Wasp sting refers to a series of clinical syndromes caused by the venom in the tail poison sac of the poisonous bee when attacking the attacked body, mainly manifested as local skin damage, systemic allergic reaction and multi-organ dysfunction syndrome (MODS) . Wasp venom can also act on the nervous system, and cause rare complications such as cerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, epilepsy, encephalitis, and Parkinson's disease, which can seriously affect the prognosis. This review will elaborate the above complications for clinical reference.

Pediatric bee sting envenomation with multiorgan challenge: A case report

Bee stings commonly result in minor reactions, but severe cases can lead to systemic complications including anaphylaxis and multiorgan dysfunction. We present a case of an 8-year-old child experiencing severe bee sting envenomation, manifesting as various organ dysfunctions including acute kidney injury and acute pancreatitis. Renal replacement therapy was effective in managing renal dysfunction. Further research is warranted to explore targeted antivenom therapies for severe bee sting reactions. Prompt recognition and a multidisciplinary approach are crucial for successful management. Further research into specific treatments is needed to improve outcomes in such cases.

The Heart Does Not Itch, But it Feels Pain: Three Cases of Kounis Syndrome

Background: Kounis syndrome is defined as the occurrence of acute coronary artery syndrome as a result of activation of inflammatory cells after conditions such as allergy, hypersensitivity, anaphylaxis or anaphylactic reactions. This case reports were presented to provide the latest knowledge on Kounis syndrome, increase awareness of this disease among healthcare providers and researchers, and promote early and appropriate diagnosis and management of this syndrome. Summary of Cases: In the first case, a 45-year-old female patient with no history of coronary artery disease developed anaphylaxis due to a locally applied anesthetic drug. This led to transient coronary artery vasospasm and acute coronary syndrome. In the second case, a 70-year-old male patient with a history of coronary artery disease developed anaphylaxis due to a bee sting. This caused rupture of the coronary artery plaque, resulting in inferior myocardial infarction. In the third case, a 73-year-old male patient with a stent in his coronary artery developed an allergic reaction/anaphylaxis to midazolam, which was administered for sedation before the biopsy procedure. This reaction resulted in restenosis of the old stent and caused an anterior myocardial infarction. Conclusion: Kounis syndrome is a life-threatening condition that requires attention. Ensuring coronary artery patency in the treatment of ischaemia is important to protect cardiomyocyte health and prevent arrhythmias. Ischaemia caused by allergens can be resolved with a combination of antiallergenic treatments. Therefore, for effective management of suspected cases of Kounis syndrome, collaboration between cardiology and allergy-immunology clinics is essential.