Document Type: Case Report
Universidad de Cartagena
Chang Gung Memorial Hospital at Linkou, Taiwan
Bee stings are commonly encountered worldwide. Various manifestations after bee sting have been described including local reactions which are common, systemic responses such as anaphylaxis, diffuse intravascular coagulation and hemolysis. We report a case of a 74-year-old man who developed neurologic deficit 5 hours after bee stings, which was confirmed to be left frontal infarction on brain CT-scan. The case does not follow the reported pattern of hypovolemic or anaphylactic shock, hemolysis and/or rhabdomyolysis, despite the potentially lethal amount of venom injected. Diverse mechanisms have been proposed to give an explanation to all the clinical manifestation of both toxic and allergic reactions secondary to bee stings. Currently, the most accepted one state that victims can develop severe syndrome characterized by the release of a large amount of cytokines.
- Bourgain C, Pauti MD, Fillastre JP, Godin M, FranÃ§ois A, Leroy JP, et al. Massive poisoning by African bee stings. Presse Med 1998;27(22):1099-101.
- Bilir O, Ersunan G, Kalkan A, Ozmen T, Yigit Y. A different reason for cerebrovascular disease. Am J Emerg Med 2013;31(5):891.e5-6.
- Ferreira RS Jr, Almeida RA, Barraviera SR, Barraviera B. Historical perspective and human consequences of Africanized bee stings in the Americas. J Toxicol Environ Health B Crit Rev 2012;15(2):97-108.
- Kalyoncu AF, Demir AU, Ozcan U, Ozkuyumcu C, Sahin AA, BariÅ YI. Bee and wasp venom allergy in Turkey. Ann Allergy Asthma Immunol 1997;78(4):408-12.
- Dikici S, Aydin LY, Saritas A, Kudas O, Kandis H. An unusual presentation of bee sting: subarachnoid hemorrhagia. Am J Emerg Med 2012;30(8):1663.e5-6.
- Rajendiran C, Puvanalingam A, Thangam D, Ragunanthanan S, Ramesh D, Venkatesan S, et al. Stroke after multiple bee sting. J Assoc Physicians India 2012;60:122-4.
- Jain J, Banait S, Srivastava AK, Lodhe R. Stroke intracerebral multiple infarcts: Rare neurological presentation of honey bee bite. Ann Indian Acad Neurol 2012;15(2):163-6.