Myocardial infarction following a bee sting

Wasp sting-induced bilateral thalamic and midbrain infarction

A male patient in his early 40s presented to the emergency department with an acute onset of respiratory distress and facial oedema, indicative of anaphylaxis. These symptoms emerged 2 hours subsequent to a wasp sting on the left side of his face. Despite initial stabilisation, the patient's state deteriorated into somnolence and disorientation. Notably, he denied any history of seizures, sensory or motor deficits, or bowel/bladder complications. Physical examination unveiled no focal neurological deficits. Routine laboratory tests and drug screening yielded no significant findings. Subsequent brain MRI with angiography exposed bilateral thalami diffusion restriction, strongly implying an acute infarction within the artery of Percheron territory, an atypical vascular variant. The sequence of events, alongside the absence of other conclusive aetiologies, indicated a wasp sting-induced thalamic infarction driven by vasogenic and thrombogenic effects of inflammatory substances.

Kounis syndrome: Acute myocardial infarction following multiple bee stings

Usually, bee sting systemic envenomation is self-limited mild allergic reaction rarely associated with systemic manifestations such as anaphylaxis, myocardial injury, encephalitis, acute kidney injury and serum sickness. Kounis syndrome also known as allergic myocardial infarction is uncommon clinical feature and reported cases are scarce in literature. Herein, we described a hypothetical case of Kounis syndrome diagnosed in a 74-year-old man initially presenting for anaphylactic reaction.

Mobitz Type-2 Heart Block After a Bee-Sting

We report the case of a patient who developed symptomatic bradycardia and Mobitz type 2 heart block one week after a single bee sting. This required implantation of a permanent pacemaker. The patient had no significant past medical history, and previous electrocardiogram (ECGs) did not show heart block or bradycardia. He has been physically active in the past and denied any such symptoms. We presume bee sting to be the cause of his symptomatic bradycardia and heart block. We also think that his heart block was reversible and has since resolved, as his most recent device check showed minimal V-pacing. The cause of his heart block can be either Kounis syndrome or Apamin-mediated calcium channel block. A detailed discussion is done separately.

Toxicological Risk Assessment of the Accidental Ingestion of a Honeybee (Apis mellifera L.) Present in Food

The aim of the present work was to evaluate the possible risk of toxic effects due to the ingestion of a honeybee (Apis mellifera L.) accidentally present in food. The methodology used in this study was a bibliographic survey of studies on the toxic effects related to honeybees, with a critical analysis of the possible risks of accidental ingestion of these insects. The amount of venom present in a bee is considered insufficient to induce detectable toxic effects in a person who ingests it by accident, and various components of the venom are destroyed by gastric secretions. However, despite the rare frequency, there is a risk of the ingestion of a bee, causing an allergic reaction to some components of the venom in sensitized individuals. In addition, pollen carried by a bee may cause an allergic reaction in a sensitive individual. Thus, the accidental ingestion of a bee present in a food does not pose the risk of toxic effects for the majority of the population but may promote allergic reactions in susceptible individuals.

Ischemic stroke following a wasp sting - a rare complication: a case report

BACKGROUND

Wasp stings are commonly encountered worldwide and result in a variety of clinical manifestations including local and systemic reactions. Neurological and vascular complications are rarely reported following a wasp sting.

CASE PRESENTATION

A 69-year-old Sri Lankan Tamil man presented to our hospital with focal neurological deficit following multiple wasp stings; the deficit was confirmed to be an acute infarction on magnetic resonance imaging scan. He was screened for metabolic risk factors which were negative and he had a normal two-dimensional echocardiogram and normal carotid arteries in carotid duplex which excluded potential sources of thromboembolism.

CONCLUSION

Treating physicians should be aware of the rare but possible complication of ischemic stroke following a case of wasp sting.

Acute kidney injury complicating bee stings - a review

Bee stings can cause severe reactions and have caused many victims in the last years. Allergic reactions can be triggered by a single sting and the greater the number of stings, the worse the prognosis. The poisoning effects can be systemic and can eventually cause death. The poison components are melitin, apamin, peptide 401, phospholipase A2, hyaluronidase, histamine, dopamine, and norepinephrine, with melitin being the main lethal component. Acute kidney injury (AKI) can be observed in patients suffering from bee stings and this is due to multiple factors, such as intravascular hemolysis, rhabdomyolysis, hypotension and direct toxicity of the venom components to the renal tubules. Arterial hypotension plays an important role in this type of AKI, leading to ischemic renal lesion. The most commonly identified biopsy finding in these cases is acute tubular necrosis, which can occur due to both, ischemic injury and the nephrotoxicity of venom components. Hemolysis and rhabdomyolysis reported in many cases in the literature, were demonstrated by elevated serum levels of indirect bilirubin and creatine kinase. The severity of AKI seems to be associated with the number of stings, since creatinine levels were higher, in most cases, when there were more than 1,000 stings. The aim of this study is to present an updated review of AKI associated with bee stings, including the currently advised clinical approach.

Acute myocardial infarction following honeybee sting

The occurrence of acute myocardial infarction following a honeybee sting has been very rarely reported in the previous literature. Possible pathogenetic mechanisms include severe hypotension, rarely hypertension and coronary vasospasm with subsequent thrombosis of coronary vessels developed after the release of vasoactive, inflammatory and thrombogenic substances contained in the bee venom. This syndrome is also known as Kounis syndrome. We report a case of a 32-year-old man who presented with acute inferior wall myocardial infarction within 3 h of honeybee sting. He was treated with thrombolytic therapy. Coronary angiogram revealed normal coronary arteries.

Myocardial injury following multiple bee stings

Envenomation by the honey bee can cause multi-organ dysfunction as a result of toxic effects and may cause a severe anaphylactic reaction. Acute myocardial ischemia is an extremely rare complication of bee envenomation. We report a case of a 58-year-old woman with acute myocardial injury following massive bee envenomation.

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.

Floor of the nose mucosa lysis and labial abscess caused by a bee sting

Hymenoptera order includes bees, which have a stinging apparatus at the tail capable of delivering venom to the affected tissues. Myocardial infarction, acute renal failure, Necrotizing fasciitis, fatal infection and hemifacial asymmetry, are some of the unusual reactions reported following hymenoptera stings. This paper reports a case of bee sting in the right floor of the nose that mimicked an odontogenic infection affecting the upper lip, canine space and nasal cavity such as in cases of infection secondary to pulpal or periodontal pathology of the anterior teeth. After a thorough clinical and radiographic examination, odontogenic infection was discarded and the diagnosis of floor of the nose mucosal lysis and lip abscess secondary to a bee sting was made. This case was successfully managed with adequate incision, drainage and antibiotics without any further complication. There are several reports of unusual reactions following hymenoptera stings. However, just a few of them referred to infections of local reactions and none of them related to the anatomic location affected in the patient of the present case. Early diagnosis and treatment prevented infection dissemination and the likelihood of tissue necrosis as in previously reported cases of Necrotizing fasciitis.

Acute stent thrombosis in a sirolimus eluting stent after wasp sting causing acute myocardial infarction: a case report

Introduction

Hymenoptera venoms contain thrombogenic substances that might be responsible for cardiovascular events independent of anaphylactic reactions.

Case presentation

We report a 55-year-old man who experienced an acute ST-elevation myocardial infarction after wasp sting. The patient presented without signs of anaphylaxis or shock. The coronary angiography showed an acute stent thrombosis of the right coronary artery. Percutanous coronary intervention was performed immediately and this is an example for a cardiovascular complication associated with a hymenoptera sting, since the vasoactive, inflammatory, and thrombogenic substances of hymenoptera venoms potentially cause stent thrombosis and myocardial ischemia. To the best of our knowledge this is the first report of acute stent thrombosis in a sirolimus-eluting stent following hymenoptera sting.

Conclusion

Stent thrombosis is a possible complication after wasp sting induced by thrombogenic substances of the hymenoptera venom.

Stroke due to bee sting

Although bee stings can cause local reactions, neurovascular complications are rare. A 60-year-old man developed a focal neurologic deficit 2 hours after multiple bee stings, which was confirmed to be acute cerebral infarctions on magnetic resonance imaging scan.

Acute myocardial infarction after a European hornet sting--a case report

The authors briefly describe an 87-year-old man who experienced an acute ST-elevation myocardial infarction in the context of an anaphylactic reaction caused by a European hornet (Vespa cabro linnaeus) envenomation. This unusual case highlights the potential cardiovascular complications associated with common insect stings such as those caused by hymenoptera. Thus, a thorough cardiovascular evaluation is essential in such cases since the vasoactive, inflammatory, and thrombogenic mediators of anaphylactic reactions may provoke myocardial ischemia.

Massive honey bee envenomation-induced rhabdomyolysis in an adolescent

Massive envenomations by honey bees are capable of causing multiorgan dysfunction as a result of the direct toxic effects of the large venom load received. Although all varieties of honey bee have the potential for these attacks, the Africanized honey bee (Apis mellifera scutellata) is the most commonly implicated subspecies. In the United States, the Africanized strain is found primarily in the southwestern states and is known for its highly defensive behavior if disturbed. Mechanisms behind the multiorgan dysfunction produced by these mass envenomations are not clearly understood. We present a case of a 13-year-old male who was stung by approximately 700 honey bees and developed progressive upper-body swelling and systemic manifestations of mass envenomation including rhabdomyolysis, renal insufficiency, and a transient transaminase elevation.

Unusual reactions to insect stings

PURPOSE OF REVIEW

A variety of unusual or unexpected reactions have occurred in a temporal relationship to insect stings. This review will summarize these case history reports in recent years. As these reactions are very infrequent, the review will also include prior reported unusual reactions attributed to insect stings.

RECENT FINDINGS

Acute encephalopathy occurred 8 days after yellow jacket stings, without any other obvious cause. There have been prior reports of other neurological reactions, myasthenia gravis, peripheral neuritis and Guillain-Barré syndrome related to insect stings. Acute renal failure with tubular necrosis has occurred following massive numbers of stings from Africanized honeybees. Nephrotic syndrome has been reported in the past following single stings. Silent myocardial infarction has occurred, probably related to acute anaphylactic symptoms immediately following a sting. There are recent reports of other pathology, diffuse alveolar hemorrhage and rhabdomyolysis and prior reports of thrombocytopenic purpura and vasculitis. As the result of ocular stings, local reactions have occurred with corneal pathology leading to cataracts. Other prior reported reactions to ocular stings include conjunctivitis, corneal infiltration, lens subluxation, and optic neuropathy. There is scarce information regarding the pathogenesis of the majority of the unusual reactions and the subsequent allergic status or risk for sting anaphylaxis of people who have had these unusual reactions.

SUMMARY

This review includes a variety of reactions, particularly involving neurological, renal and cardiovascular symptoms, related to insect stings. It is important that clinicians be aware of this relationship when assessing people with these reactions and address future prophylaxis.

Acute myocardial infarction in a professional diver after jellyfish sting

To our knowledge, acute myocardial infarction after jellyfish envenomation has not been reported previously. We describe a previously healthy 45-year-old male diver who had an acute inferior myocardial infarction with right ventricular involvement after a jellyfish sting on his left forearm while diving in the Gulf Sea. The patient had a normal controlled ascent after the incident. He had no risk factors for coronary artery disease, and cardiac catheterization revealed normal coronary arteries. Acute myocardial infarction should be considered in patients who experience chest pain or have hemodynamic compromise after jellyfish envenomation.