Bee Sting Research Articles

Anaphylactic reaction to a wasp sting treated with eppikajutsuto: a case report

Anaphylactic reaction to a wasp sting treated with eppikajutsuto: a case report

Abstract 13185: Getting at the Heart of Allergies: A Case Series on Kounis Syndrome

Kounis Syndrome (KS) is a complex medical condition where acute coronary syndrome coincides with allergic reactions. KS presents a unique clinical challenge due to its varied presentation and simultaneous management of an allergic response and a cardiac event. This study aims to further our understanding of this underreported condition to improve outcomes in patients. We demonstrated the intricacies of KS by examining two case studies. In Case 1, a 51-year-old male suffered a myocardial infarction after a wasp sting. Workup revealed elevated tryptase levels and mastocytosis on bone marrow biopsy concerning for mast cell activation syndrome. In Case 2, a 48-year-old female was diagnosed with vasospastic angina exacerbated by exposure to various allergens and associated with elevated histamine levels. Both patients underwent coronary angiography which demonstrated no obstructive coronary artery disease. Functional coronary angiography with acetylcholine provocation confirmed a predisposition for coronary vasospasm. Both patients were treated with anti-anginals and antihistamines. A literature review was performed to describe the pathophysiology, diagnosis, and treatment of KS. The underlying pathophysiology includes mast cell degranulation, where the release of inflammatory mediators like histamine and tryptase provokes coronary vasospasm, plaque rupture, and thrombus formation. With prompt recognition and appropriate management, the prognosis of KS is favorable. A greater understanding of KS can support clinicians in delivering quality care for patients. Our cases demonstrate the importance of maintaining a high index of suspicion in patients exhibiting an acute allergic reaction with concurrent evidence of cardiac ischemia. While the current literature provides some management guidance, additional research is required to improve our mechanistic understanding, diagnostic criteria, and therapeutic strategies.

Epidemiological study of bee stings in the state of Paraiba, Northeastern Brazil, from 2015 to 2019

Introduction: In Brazil, envenomation by bee sting is a public health problem due to its incidence in all regions of the country, as well as the severity of cases. Despite the medical and sanitary importance, the literature on this topic in Brazil is scarce, in the Northeast region. Objective: To describe the epidemiological characteristics of bee stings in Paraíba, in the Northeast region of Brazil, from 2015 to 2019. Methods: The current study is a descriptive and retrospective epidemiological investigation conducted through the recovery of secondary data made available by the database from the Ministry of Health Notification Information System. Results: A total of 1,151 cases were analyzed, and they were reported during all the months of the period of the study and were more frequent in the regions Agreste and Sertão of the Paraíba. The victims were men aged 20 to 59 years. Most individuals received medical assistance within 3 hours of the incident. The cases were classified as mild and progressed to cure. Conclusion: In Paraíba, bee stings have increased in recent years, especially in regions with a semi-arid climate. In addition, this study provides data that may be used in the development of educational health actions to promote the prevention and control of bee stings in this region.

Clinical Manifestations and Risk Factors Associated with 14 Deaths following Swarm Wasp Stings in a Chinese Tertiary Grade A General Hospital: A Retrospective Database Analysis Study.

The objective was to evaluate the poisoning severity score (PSS) as an early prognostic predictor in patients with wasp stings and identify associated clinical characteristics and risk factors for mortality. A total of 363 patients with wasp stings at Suining Central Hospital between January 2016 and December 2018 were enrolled. Within the first 24 h of admission, the poisoning severity score (PSS) and the Chinese expert consensus on standardized diagnosis and treatment of wasp stings (CECC) were utilized for severity classification, and their correlation was examined. Patients were then divided into survival and death groups based on discharge status. Logistic regression analysis was employed to analyze factors influencing patients' outcomes. The mortality of wasp sting patients was 3.9%. The PSS and CECC were found to correlate for severity classification. Additionally, female gender, age, number of stings, and PSS were identified as independent risk factors for mortality in wasp sting patients. Combining these four factors yielded an AUC of 0.962 for predicting death. PSS aids in early severity classification of wasp stings. Female gender, age, number of stings, and PSS were independent mortality risk factors in these patients.

A Case Report of Kounis Syndrome Developing Anaphylaxis Secondary to Vitamin B and C Infusion

Kounis syndrome is a condition characterized by temporary coronary spasm, reduction in coronary blood flow and myocardial ischemia by activated mast cells as a result of an abnormal immune reaction to a drug or molecule. It is also called allergic angina and allergic myocardial infarction. It was first described by Kounis and Zarvas in 1991. (1) Kounis syndrome can be observed in all age groups regardless of the history of coronary artery disease. Kounis syndrome may occur due to environmental factors such as drugs, intracoronary stent implantation, foods, insect bites, bee stings, pollen, latex exposure etc. In our case report, acute coronary syndrome occurring during anaphylaxis secondary to vitamin B and C infusion, which is frequently used in clinical practice, will be explained.

The predictive value of the systemic inflammatory response index for the occurrence of multiple organ dysfunction syndrome in patients with wasp sting injury

Wasp sting injuries pose a significant threat to public health, especially in areas with abundant trees. Mortality rates are alarmingly high, with reports indicating that up to 70% or more of cases result in multiple organ dysfunction syndrome (MODS). It is crucial for emergency and critical care physicians to promptly identify and implement effective measures to reduce the occurrence of MODS in patients who have been stung by wasps. Therefore, finding a reliable predictive indicator is of utmost importance. We conducted a retrospective study, and clinical data of 226 hospitalized patients with wasp sting from July 2013 to April 2023 in the First College of Clinical Medicine Science, China Three Gorges University were collected. The patients were divided into MODS group and non-MODS (NMODS) group, and the general data, clinical symptoms, laboratory indexes, and prognosis were compared between the two groups. The indicators with significant differences in univariate analysis were included in the multivariate Logistic regression analysis to analyze the independent risk factors for MODS. The value of systemic inflammatory response index (SIRI) in predicting the occurrence of MODS in wasp sting was analyzed by using the receiver operating characteristic curve (ROC curve). Of the 214 patients with wasp sting, 109 cases were in the NMODS group, and 105 cases were in the MODS group. The SIRI was 1.6 (0.7, 3.6) and 12.2 (5.2, 23.3) in the NMODS group and MODS group, respectively, with a significant difference between the two groups (P ＜ 0.001). SIRI was an independent risk factor for MODS in patients with wasp sting; the AUC of SIRI in predicting MODS in wasp sting was 0.886 (P ＜ 0.001), and the optimal cutoff value was 6.39, with a sensitivity of 71.43% and a specificity of 94.5%, which had prediction value. Allowing for early identification and enabling doctors to intervene and provide timely treatment. SIRI was defined as follows: SIRI = neutrophil count × monocyte count/lymphocyte count.

Binodal Disease after a Hornet Bee Sting.

Binodal Disease after a Hornet Bee Sting.

A Retrospective Study on Patients Bitten or Stung by Arthropods Admitted to Major Hospitals in Jaffna District

Though a considerable number of arthropod stung or bitten patients seek medical assistance in Jaffna District, only few literatures are available. With this background, this retrospective study was designed to study the holistic pattern of arthropod stings or bites reported in Jaffna District. This institutional based retrospective descriptive study was carried out at major hospitals in Jaffna District. Basic demographic data, type of arthropods, site of bite and other recorded clinical manifestations were extracted to a data sheet from the BHTs for a period of one year. The data were analyzed using statistical software SPSS version 21. Ethical clearance was obtained from the Ethical Review Committee of the Faculty of Medicine, University of Jaffna. During the study period 1030 patients were reported to the Base Hospitals in the Jaffna District and the Teaching Hospital, Jaffna. Among them 57% were male and the age ranges from 1 to 86 years. Majority of them were from the MOH divisions of Chavakacheri (30%) and Tellipalai (22%) followed by PointPedro (18%). Most of them had unknown bite (36%) followed by wasp stings (23%) and white scorpion (15%) stings. Legs (36%) were the predominant site of bite followed by arm (31%) and head and neck (15)%. This study reveals 72% of the patients reported pain whereas 44% had swelling at the site of bite. Most of the patients (78%) stayed in the hospital for one day and others (22%) stayed for two days, and no fatality was recorded during the study period. In conclusion, arthropod stings or bites need not be neglected anymore and further in depth studies of arthropod biology and risk factors are paramount in order to help the health authorities in the primary prevention.

Bee sting induced facial nerve palsy

Bee stings are one of the common clinical scenarios in day-to-day clinical practice in Sri Lanka. The spectrum of bee sting-related complications can vary from simple allergic reactions to life-threatening conditions and sometimes death. Anaphylaxis, cardiogenic shock, respiratory arrest, acute renal failure, vasospasm-related ischaemia, and acute pulmonary oedema are some of the life-threatening conditions. Neurological manifestations such as acute cerebral infarction, acute demyelinating polyneuropathy, encephalitis, transverse myelitis, and optic neuritis are also reported. We report a rare presentation of unilateral facial nerve palsy following bee stings in a 63-year-old woman, who fully recovered with treatment. Received 11 December 2022, accepted 05 February 2023.

Summer poisoning hazards

There is a seasonal risk with some poisons and in the summer, when stinging insects and adders are more active, there is a risk of envenomation. Diagnosis of an adder bite may be missed in horses, as the biting event is rarely witnessed. Envenomation may result in local swelling and occasionally, systemic effects. Multiple bee stings are particularly hazardous as this can result in multi-organ involvement, which may be fatal. Grazing on some plants, such as ragwort or bracken, for a prolonged period can also result in poisoning as ragwort contains pyrrolizidine alkaloids which cause liver failure and bracken contains an enzyme that has an anti-thiamine effect, inducing thiamine deficiency. Photosensitisation following exposure to plants containing phototoxins and bright sunlight is also a risk in summer. Treatment of plant poisoning in horses is generally supportive and involves removing the plant, providing good quality food and supportive care. Thiamine supplementation may be required in severe cases of bracken poisoning. Animals should be protected from sunlight following exposure to a phototoxin, with supportive management of skin lesions. Management of adder bite is supportive with administration of adder antivenom. Multiple bee stings require aggressive supportive care.

A Rare Case of Acute Lower Limb Ischemia following Bee Sting

Bee sting entails allergic reaction that can be severe, sometimes even lethal as seen in our case report. These reactions can occur immediately after being stung. We report a case with arterial occlusion and severe ischemia in the lower limb a few hours after multiple bee stings. A 67-year-old male, a known case of hypertension and diabetes mellitus since 15 years and recently diagnosed with hypothyroidism, presented to the emergency department with multiple bee stings all over the body. Hence, he had developed bilateral lower limb edema with blackening of the left foot, which was gradually progressive in nature. Pedal pulsation were not palpable. After emergency treatment patient was subjected to Computed Tomography Angiography, suggestive of bilateral thrombotic occlusion of distal third of anterior tibial artery, posterior tibial artery and dorsalis pedis artery .patient was treated with systemic thrombolytic therapy and Anticoagulation.

The Enzymatic Role in Honey from Honey Bees and Stingless Bees

Abstract: A variety of biomolecules known as enzymes are found in honey and originated from bees and plant nectars. The plant yields nectar that aids bees in producing honey. Diastases, invertases, glucosidases, glucose oxidases and proteases are the common enzymes present in honey and highly sensitive toward UV-vis light, heat, and microwave energy. Among all enzymes, invertase and diastase have been used for assessing the freshness of honey. The enzyme's capacity to transform amylose into glucose enhances the sweetness and flavor of honey. The role of enzymatic reactions in two types of honey, based upon bee sting morphology, namely honey from honey bees (HB) and stingless bees (SB) are discussed in this review. Enzymes that act as the main ingredient in honey production are comprehensively discussed for their significance in producing good quality and therapeutic properties of honey.

Counselling Farmers on Improving the Yield of Flowering Crops through Integrated Apicultural Farming for Wealth Creation

This study focused on counselling farmers on improving the yield of flowering crops through integrated apicultural farming for wealth creation. The researchers used a descriptive survey research design and a sample of 50 participants, including traditional bee farmers, staff of agricultural education, and intending apiarists which were purposively selected from a public state owned university, Bamidele Olumilua University of Education, Science and Technology (BOUESTI). Data was collected using a well-structured questionnaire, which was validated by agricultural science and counselling education experts. The instrument's reliability was established through a pilot test, and the data analysis involved descriptive statistics such as frequency, percentage, and mean scores. The two major focus of the questionnaire was to identify various challenges that hinder subsistence farming of apiculture as wealth creation strategies and to also establish the fear level of those who are interested in bee keeping but are afraid of sting. The challenges identified from the findings of this study included poor credit services, shortage of forage, inadequate training and manpower, poor apiculture policies, diseases affecting honey bees and poor utilization of technology. In addition, the study found that subsistence farmers and intending apiarist exhibited high levels of apiphobia, which negatively impacted their engagement in apiculture. The researchers through group counselling educated participant on strategies for improving apiculture farming, such as effective crop production management, planting of flowering crops like beans, maize, and mango, and selecting suitable apiary locations away from windy areas. To unlearn anxiety and phobia of bee sting, systematic desensitization (a Counselling Therapy) was used to assist both subsistence farmers and intending apiarists. Keywords: Apicultural Farming, Wealth Creation, Apiphobia, Systematic Desensitization. Journal Reference Format: Makinde, V.I. & Ogunjobi, P.O. (2023): Counselling Farmers on Improving the Yield of Flowering Crops through Integrated Apicultural Farming for Wealth Creation. Humanities, Management, Arts, Education & the Social Sciences Journal. Vol. 11. No. 2, Pp 19-32. www.isteams.net/humanitiesjournal. dx.doi.org/10.22624/AIMS/HUMANITIES/V11N2P3

Severe pathological changes in the blood and organs of SD rats stung by honeybees

With the development of beekeeping, the risk of bee stings in humans is increasing. Severe and life-threatening toxic reactions can occur after multiple bee stings, and their pathogenesis has not been elucidated. To understand the effect of multiple bees (Apis mellifera) stings on the organism in a short period, we stung rats once and five times, respectively. Serum and organs were obtained after 3 h for analysis. The results indicated that skin erythema was more pronounced and hemolysis was more severe as the number of puncture wounds increased. After being stung by five bees, rats had dramatically higher serum levels of direct bilirubin, aspartate aminotransferase, creatine kinase and lactate dehydrogenase, producing more differential metabolites that affected mainly four metabolic pathways. In addition, the liver, kidney and heart showed significant congestion and inflammation. This study helps explain the organism's clinical response to bee venom and may be valuable in treating toxic reactions following bee stings.

Characterization of the Molecular Diversity and Degranulation Activity of Mastoparan Family Peptides from Wasp Venoms.

Wasp stings have become an increasingly serious public health problem because of their high incidence and mortality rates in various countries and regions. Mastoparan family peptides are the most abundant natural peptides in hornet venoms and solitary wasp venom. However, there is a lack of systematic and comprehensive studies on mastoparan family peptides from wasp venoms. In our study, for the first time, we evaluated the molecular diversity of 55 wasp mastoparan family peptides from wasp venoms and divided them into four major subfamilies. Then, we established a wasp peptide library containing all 55 known mastoparan family peptides by chemical synthesis and C-terminal amidation modification, and we systematically evaluated their degranulation activities in two mast cell lines, namely the RBL-2H3 and P815 cell lines. The results showed that among the 55 mastoparans, 35 mastoparans could significantly induce mast cell degranulation, 7 mastoparans had modest mast cell degranulation activity, and 13 mastoparans had little mast cell degranulation activity, suggesting functional variation in mastoparan family peptides from wasp venoms. Structure-function relationship studies found that the composition of amino acids in the hydrophobic face and amidation in the C-terminal region are critical for the degranulation activity of mastoparan family peptides from wasp venoms. Our research will lay a theoretical foundation for studying the mechanism underlying the degranulation activity of wasp mastoparans and provide new evidence to support the molecular design and molecular optimization of natural mastoparan peptides from wasp venoms in the future.

Profiling the disintegration of BRPs released by massive wasp stings using serratiopeptidase: An in-silico insight

Serratiopeptidase is a multifaceted therapeutic enzyme renowned for its anti-inflammatory, analgesic, anti-biofilm, fibrinolytic, and anti-edemic properties. It is vital to uncover more about the assets of such efficacious enzyme in order to facilitate their contribution in all health-related issues, notably inflammatory ailments. The current study sought to determine whether serratiopeptidase would disintegrate bradykinin related peptides (BRPs) from wasp venom in the same manner as it does with human bradykinin. To accomplish this objective, we docked selected BRPs onto the binding pocket of wild and previously identified mutant (N412D) of serratiopeptidase. Based on their docked scores, the top two BRPs were selected, and their conformational behavior was analyzed employing molecular dynamics studies. Additionally, thermodynamics end-state energy analysis reported that both the complexes exhibited higher stability and identical ΔG values when compared to the reference complex. Further, we condemned the external pulling forces on both peptides to observe the force needed in the disassociation process to endorse the binding affinity findings in terms of unbinding mechanism. This analysis suggested that BRP-7 (Wasp kinin PMM1) peptide was tightly anchored and laid out the highest pulling force to get detach from the active pocket of serratiopeptidase in contrast to the BRP-6 peptide. The current study endorses up the present findings and paves the way for serratiopeptidase to be used as an anti-angioedemic peptidase as well as a fixed-dose combination (FDC) in hypotensive drugs.

Hyper‐IgE syndrome presenting with early life craniosynostosis in monozygotic twin sisters

<scp>Hyper‐IgE</scp> syndrome presenting with early life craniosynostosis in monozygotic twin sisters

Concern for an Antibiotic-Resistant Skin and Soft Tissue Infection after a Bee Sting

Concern for an Antibiotic-Resistant Skin and Soft Tissue Infection after a Bee Sting

Outcomes of wasp and bee stings in Taiwan

Background The families of Hymenoptera causing commonly poisonous animal stings in Taiwan include Apoidea (bee) and Vespidae (wasp). This study aimed to investigate the epidemiologic, clinical characteristics, and outcomes of the severity of envenomation following wasp or bee stings in Taiwan. Methods We conducted a retrospective study by identifying all wasp and bee sting-related envenomation reported to the Taiwan National Poison Control Center between January 2001 and November 2021. Data were reviewed and abstracted by two independent reviewers. We then used ordinal logistic regression analysis to find potential predictors of severe wasp and bee sting-related envenomation. Results In Taiwan, bee or wasp stings mainly occur in late summer and autumn. A total of 611 patients were reported to the Taiwan National Poison Control Center with 7.5% resulting in severe or fatal envenomation. Four-hundred and forty-one patients were eligible for the final analysis of the predictors of severity. Logistic regression analysis showed that a greater number of stings, being stung by wasps, older age, and stings over the body were significant predictors for greater severity. The systemic effects following wasp and bee sting included anaphylactic reaction, prolongation of activated partial thromboplastin time, rhabdomyolysis, acute kidney injury, and elevated liver enzymes. Conclusions Wasps generally inflicted more severe envenomation than bees. Only 7.5% of patients had severe or fatal outcomes. Patients with older age, multiple stings, and/or multiple sites of stings were more likely to have severe outcomes.

Kounis syndrome: Beware of bee sting!

The Kounis syndrome is described as acute coronary syndrome associated with allergic reaction. It can be triggered by various causes and is associated with significant morbidity and mortality. It is important for physician to recognize this syndrome and its clinical significance as it can be misdiagnosed and the management requires attention to both cardiac and anaphylactic pathophysiology. We reported a case of acute infero-posterior myocardial infarction triggered by bee sting, and discussed its possible underlying mechanism, treatments and its successful outcome.