Honeybee Sting Research Articles

Acute Axonal Polyneuropathy Following Honey-Bee Sting

Hymenoptera stings lead to a myriad of neurologic manifestations by the mechanism of immediate or delayed hypersensitivity reactions. The more common form of polyneuropathy associated with these stings is the acute inflammatory demyelinating type. We describe a 6-year-old girl, who developed progressive, symmetrical, ascending weakness within 3 days after a bee sting. Serial nerve conduction studies confirmed acute, motor-predominant axonal polyneuropathy. Use of intravenous immunoglobulin induced halt of progression, prompt stabilization and a gradual recovery. This case highlights that even a single honey-bee sting can result in acute-onset axonal variety of polyneuropathy in children.

Death Caused by Honey Bee Stings: Case Report

A bee sting is always potentially serious. The severity and duration of a reaction can vary from one person to another. In addition, one's own reaction to a bee sting may differ between occurrences. Most persons experience a local non-serious allergic reaction to bee venom. However, depending on the location and number of bee stings received, as well as the ever-present possibility of a severe allergic reaction to bee venom, a serious reaction can be precipitated that can be life-threatening. A 49 years old man having a history of allergic reaction to bee sting was found dead near to 9 nests. There were many dead honey bees on him. External examination of the body showed more than 50 stings all over the body. Upon medico-legal autopsy, pulmonary edema and swelling in laryngeal area were the internal findings. History of allergy, autopsy findings and findings obtained from crime scene investigation were evaluated together and the cause of death was concluded to be anaphylactic shock resulted from bee stings.

Massive attack by honeybees in a German shepherd dog: description of a fatal case and review of the literature.

In the present study, a fatal case caused by honeybee (Apis cerana) stings was documented in a female German shepherd dog that was presented at the Veterinary Teaching Hospital, University of Agriculture Faisalabad, Pakistan. Characteristic clinical signs included hematuria, hematemesis, incoordination and convulsions along with evidence of massive honeybee attack supported the diagnosis of envenomation. The dog was treated with dexamethasone and diphenhydramine, but it did not respond to therapy and died. This outcome could be avoided if we had a bee antivenom available for treating envenomated patients.

Honeybee sting of the sclera: occular features, treatment, outcome and presumed pathogenesis

Ocular bee sting injury has caused several reactions in the eye but has rarely been reported among local African farmers, and Nigerians in particular. This case seeks to report the first ocular and external eye reactions following a honey bee sting of the eye through the sclera, highlighting the treatment and outcome. Oral interview, clinical examination and external photographs were used to obtain and document findings. Medical treatment was instituted as soon as subject presented. There was complete inflammatory resolution within a week, normal vision and no evidence of stinger migration after four weeks of follow up. The wound site healed with ciliary staphyloma. The role of physical properties, immunological and genetics interplay and the presumed pathogenesis is further discussed. Health education on early presentation and avoidance of harmful traditional eye medications should be promoted among the farming populations in our communities, in order to prevent blinding complications

Rates of honeybee sting hypersensitivity in San Antonio during honeybee colony collapse disorder

The abrupt disappearance of honeybees (Apis mellifera) from a hive or colony has been described as colony collapse disorder (CCD). Although the disappearance of bees from hives or colonies has occurred throughout the history of apiculture, the term colony collapse disorder was first applied to the dramatic rise in disappearance of Western colonies in North America in 2006. There is enormous potential economic impact of CCD because many agricultural crops worldwide are pollinated by bees. For example, the California almond industry is worth $2 billion annually and relies on over 1 million hives for cross-pollination.

Evaluation and Validation of A Bee Venom Sting Challenge Performed by A MICRO-Syringe

The honeybee sting challenge is considered a reliable procedure to evaluate the efficacy of specific immunotherapy, but it is difficult and unpractical to perform in clinical practice, since live insects are required. We assessed the feasibility and reliability of a challenge test using a micro-sirynge, and compared the procedure to sting challenge.

Acute myocardial injury in multiple bee stings - Case report

Acute myocardial injury due to honey bee sting is rare, only a few studies have discussed the relationship between honey bee sting and myocardial injury. Massive envenomation by honey bees can cause multiorgan dysfunction due to toxic effects of massive envenomation and systemic anaphylactic reactions.

Evaluation and validation of a bee venom sting challenge performed by a micro-syringe

BackgroundThe honeybee sting challenge is considered a reliable procedure to evaluate the efficacy of specific immunotherapy, but it is difficult and unpractical to perform in clinical practice, because live insects are required. ObjectiveTo assess the feasibility and reliability of a challenge test using a micro-syringe, and compared the procedure with sting challenge. MethodsPatients on bee venom immunotherapy and without systemic reactions at field sting were enrolled. They underwent a sting challenge with live bee, and large local reactions were assessed up to 48 hours. Those patients displaying systemic reactions at the sting challenge were excluded from the syringe challenge for ethical reasons. The syringe challenge was done by injecting 0.5 μL fresh unfiltered bee venom at 2 mm depth (the length of the sting left by a bee). The same follow-up as at the first challenge was performed. Bee-specific immunoglobulin E (IgE) and tryptase were measured after each challenge. ResultsNineteen patients underwent the sting challenge with live bees. Four had immediate systemic reactions (urticaria or asthma) and were excluded from the second challenge. The remaining 15 patients with large local reaction underwent the syringe challenge. No significant difference was seen in the maximum area of the large local reactions between the challenge with live bees and the syringe challenge. Also, no change was seen in tryptase and specific antibodies. ConclusionThis preliminary study suggests that the micro-syringe challenge with honeybee venom is feasible and produces results indistinguishable from those of the traditional sting challenge.

Corneal honey bee sting: endoilluminator-assisted removal of retained stinger

To report the clinical findings and a novel method of removal of bee sting using an endoillumination light source the following methods were used: clinical presentation, slit-lamp photographs, serial endothelial images and surgical management of a case of retained bee sting in the cornea. The bee sting was surgically removed by forceps under focal illumination with an endoillumination light source. Topical steroids and cycloplegics were given postoperatively to control the inflammation. The patient had complete visual recovery and partial resolution of endothelial changes after 1 year of treatment. The clinical picture of a corneal honey bee sting resembles keratouveitis. Focal corneal infiltrate and associated low-grade uveitis tend to persist if treated with topical steroids only. Early recognition and prompt removal of the stinger may help in the early resolution of anterior segment inflammation and prevent irreversible damage to endothelial cells.

90 Improving the Diagnosis of Hymenoptera Venom Allergy

BackgroundUp to 3% of the general population suffers from potentially life-threatening systemic reactions after honeybee and wasp stings. Unfortunately, there are still individuals who have a convincing history of an anaphylactic event, but lack the necessary diagnostic, making difficult the decision for immunotherapy. Our aims were to evaluate the feasibility of using recombinant allergens in the Basophil activation test (BAT) for the diagnosis of Hymenoptera allergy and to develop a high-throughput diagnostic device combining the advantages of basophil activation tests with a panel of recombinant allergens: rVes v 1, rVes v 2, rVes v 3, rVes v 5, rApi m 1, rApi m 2, rApi m 3 and rApi m 5.MethodsBasophil activation test (BAT) and measurement of specific IgE was performed on 47 wasp venom, 14 Honeybee venom allergic patients and 17 healthy controls. Specificity and sensitivity of BAT performed with recombinant His-tag purified wasp venom allergens Ves v 1, Ves v 2, Ves v 3 and Ves v 5, recombinant honeybee venom allergens Api m 1, Api m 2, Api m 3 and Api m 5 and commercial extracts have been compared. Each patient had a history of grade I or II anaphylaxis after an insect sting. All patient sera were collected before initiation of SIT.ResultsBAT performed with the panel of recombinant allergens markedly increased the specificity and the sensitivity in the detection of wasp venom allergic subjects.ConclusionsBasophil activation test provides a valuable new in vitro method for the detection of allergy to wasp venom and may supplement routine tests for allergy diagnosis in problematic cases. Recombinant allergens might help to dissect relevant allergens for basophil degranulation.

Bee Venom Challenge By A Micro-syringe: Validation Procedure

The honeybee sting challenge is considered a reliable diagnostic procedure, expecially for experimental purpose, but difficult to perform in clinical practice. Objective: we assessed the feasibility and reliability of a challenge test using a micro sirynge and compared to the standard procedure.

Acute polyradiculoneuropathy following honey bee sting

Neurological complications following honey bee sting are rare. We report a case of a 3-year-old girl who developed acute polyradiculoneuropathy following honey bee sting, which was diagnosed by nerve conduction studies.

Low sensitivity of commercially available rApi m 1 for diagnosis of honeybee venom allergy

Low sensitivity of commercially available rApi m 1 for diagnosis of honeybee venom allergy

Three Days Rush Venom Immunotherapy in Bee Allergy: Safe, Inexpensive and Instantaneously Effective

Background: Rush venom immunotherapy (VIT) is highly effective in vespid venom allergy, but comparable data regarding bee venom (BV) allergy are sparse. We evaluated its safety, efficacy and cost in BV-allergic patients. Methods: Conventional or rush VIT were offered to all patients with systemic reaction to insect sting. Rush VIT was also given to hyperreactive patients who failed to reach the maintenance dose with conventional VIT due to multiple systemic reactions. In BV-allergic patients, honeybee sting challenge was performed within 1 week after reaching the maintenance dose. Results: 179 patients, some of them allergic to more than one venom, received 246 rush VIT courses. Bee VIT was administered to 132 patients (73.7%); 173 patients (96.6%) reached the maintenance dose. The incidence of systemic reactions was 29.6%. They were more common in VIT with BV than with vespid venoms (31.1 and 16.3%, respectively, p = 0.01). After excluding the hyperreactive subgroup (n = 20), this difference was not significant (23.7 and 16%, respectively, p = 0.19). Despite the high incidence of systemic reactions (15 of 20, 75%) among hyperreactive patients, 17 patients (85%) achieved the maintenance dose. Sting challenges resulted in systemic reaction in 4 of 8 (50%) hyperreactive patients and in 2 of 47 (4.3%) ordinary patients. The cost of rush VIT was 41% of that of conventional VIT. Conclusions: Rush VIT with BV is safe, instantaneously effective, less expensive and enables most patients with previous failures of conventional VIT to reach the maintenance dose.

Gangliosides inhibit bee venom melittin cytotoxicity but not phospholipase A 2-induced degranulation in mast cells

Sting accident by honeybee causes severe pain, inflammation and allergic reaction through IgE-mediated anaphylaxis. In addition to this hypersensitivity, an anaphylactoid reaction occurs by toxic effects even in a non-allergic person via cytolysis followed by similar clinical manifestations. Auto-injectable epinephrine might be effective for bee stings, but cannot inhibit mast cell lysis and degranulation by venom toxins. We used connective tissue type canine mast cell line (CM-MC) for finding an effective measure that might inhibit bee venom toxicity. We evaluated degranulation and cytotoxicity by measurement of β-hexosaminidase release and MTT assay. Melittin and crude bee venom induced the degranulation and cytotoxicity, which were strongly inhibited by mono-sialoganglioside (G M1), di-sialoganglioside (G D1a) and tri-sialoganglioside (G T1b). In contrast, honeybee venom-derived phospholipase A 2 induced the net degranulation directly without cytotoxicity, which was not inhibited by G M1, G D1a and G T1b. For analysis of distribution of Gα q and Gα i protein by western blotting, lipid rafts were isolated by using discontinuous sucrose gradient centrifuge. Melittin disrupted the localization of Gα q and Gα i at lipid raft, but gangliosides stabilized the rafts. As a result from this cell-based study, bee venom-induced anaphylactoid reaction can be explained with melittin cytotoxicity and phospholipase A 2-induced degranulation. Taken together, gangliosides inhibit the effect of melittin such as degranulation, cytotoxicity and lipid raft disruption but not phospholipase A 2-induced degranulation in mast cells. Our study shows a potential of gangliosides as a therapeutic tool for anaphylactoid reaction by honeybee sting.

Accidents And Mortality From Honey-bee Stings In Mexico

Accidents And Mortality From Honey-bee Stings In Mexico

Expression and Function of C5a Receptor in a Fatal Anaphylaxis After Honey Bee Sting*

The mechanisms leading to death from anaphylaxis after insect sting involve antigen cross-linkage of antibody molecules that activate immunoglobulin receptors on inflammatory cells. The aim of our study was to investigate the pathomorphology and the expression of C5aR in fatal anaphylaxis in a patient after a fatal insect sting. A 38-year-old women was stung by a honeybee. C5R1 expression was detected in many dilated capillaries in the lungs. Pulmonary epithelial cells did not bind the monoclonal antibody for C5R1; however, intensive cytoplasmic staining was detected in endothelial cells. The findings of this case provide evidence for an active role of complement in fatal anaphylaxis elicited by bee venom. C5aR detection could be useful in the identification of sudden death cases because of unwitnessed fatal insect sting cases. Authors can recommend this immunohistochemical analysis on all sudden unexpected deaths outdoors where a possible bee sting might occur.

EFFECT OF WET CUPPING THERAPY ON VIRULENT CELLULITIS SECONDARY TO HONEY BEE STING – A CASE REPORT

Cellulitis is clinical condition that is caused by the inflammation of sub-cutaneous tissue. Conventional treatment of cellulitis is based on the use of antimicrobials. Treatment by Cupping is one of the oldest ways of healing for more than 5000 years; now reemerging in this modern age and is being practice in many countries such as USA, UK, Germany and China. This is the first reported case in which, twice a healthy subject was stung by honeybee and was effectively treated by cupping therapy. In the first attack of honeybee sting, a virulent cellulitis developed on the ventral surface of the right forearm. The subject was treated with antimicrobials with no response. Later as an adjunctive treatment, cupping therapy was applied at the site of cellulitis with remarkable and immediate clinical recovery. Interestingly, 45 days later, same individual was again stung by honeybee on the planter surface of the right big toe and on this occasion immediately cupping was applied; that gave quick relief and no inflammation developed. Cupping therapy may be an effective measure in the treatment of honey bee sting induced cellulitis.

Fanconi syndrome following honeybee stings

A 32-year-old gentleman was attacked by honey bees about 8 months and immediately afterwards his eyelids, cheeks and pinnae became swollen, red, and tender. However, the patient did not develop any renal or serum sickness symptoms and his physical examination and laboratory investigations were normal. He recovered completely. A week later, while working on his farm, he experienced a sudden loss of muscular tone in all four limbs without losing his consciousness. The medical examination subsequently revealed flaccid quadriparesis associated with a serum potassium of 2.1 mEq/L. He was also found to have hyperchloremic metabolic acidosis with normal anion gap and preserved ability to acidify urine to a pH of 5.5. These findings were suggestive of proximal renal tubular acidosis (Fanconi syndrome). Other abnormalities like hypophosphataemia, hypouricemia, renal glucosuria and high urinary excretion of calcium, phosphorus and uric acid further supported the diagnosis of proximal tubular dysfunction. The renal biopsy revealed dense lymphocytic interstitial infiltrate, a feature often seen in Sjogren's syndrome, in which at least 50% of patients fail to acidify urine. In our patient, thorough search for other causes of proximal renal tubular acidosis was negative.

Giant Asian honeybee or Bambara stings causing myocardial infarction, bowel gangrene and fatal anaphylaxis in Sri Lanka: a case series

The sting of Giant Asian honeybee ( Apis dorsata) or Bambara in Sinhala and Karunge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions, which could be fatal in sensitized individuals. We reported myocardial infarction, bowel gangrene and fatal anaphylaxis in a prospectively proven case series and the association of these uncommon complications with delayed removal of stingers from the patients' skin.