Bee sting envenomation severe cases in Manaus, Brazilian Amazon: clinical characteristics and immune markers of case reports

Mendonça-da-Silva, Iran; Monteiro, Wuelton Marcelo; Sachett, Jacqueline de Almeida Gonçalves; Barbosa, Endila Souza; Cordeiro-Dos-Santos, Marcelo; Lacerda, Marcus Vinícius Guimarães; Melo, Gisely Cardoso de; Costa, Allyson Guimarães; Val, Fernando

doi:10.1590/0037-8682-0319-2021

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Wasp venom can initiate a series of immune responses and even severe envenomation syndrome in the human body, resulting in the massive release of various cytokines and acute inflammatory storm[ 10 ]. These inflammatory factors can cause tissue and organ damage, including the respiratory system[ 12 ], leading to ARDS in severe cases[ 13 ]. Wasp venom is a complex neuromuscular blocking agent, and its active substance can affect acetylcholine synthesis and release.…”

Section: Discussionmentioning

confidence: 99%

Acute respiratory distress syndrome following multiple wasp stings treated with extracorporeal membrane oxygenation: A case report

Cai¹,

Xu²,

Zhang³

et al. 2022

World J Clin Cases

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BACKGROUND It is necessary for clinicians to be aware of a rare but possible acute respiratory distress syndrome (ARDS) complication caused by multiple wasp stings. Severe ARDS has a high mortality rate but no specific pharmacotherapies have been identified to date. This case study presents the first case of severe ARDS caused by multiple wasp stings, treated successfully with extracorporeal membrane oxygenation (ECMO). It also emphasizes the effectiveness of early ECMO treatment for severe ARDS with persistent hypoxemia. CASE SUMMARY A 24-year-old woman was admitted to the emergency department after being stung by more than 10 wasps within a 30-min period, with clinical symptoms of multiple rashes, dizziness, chest tightness, nausea, and vomiting. On the 2 nd day of admission, the patient developed progressive dyspnea. The patient was diagnosed with ARDS based on clinical manifestations and lung computed tomography (CT) scan. Because of the progressive dyspnea, the intensive care unit physician performed endotracheal intubation and continued to provide ventilator support, but the patient’s respiratory distress worsened, as indicated by the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen. Veno-venous ECMO was initiated for 6 d. On day 7 of admission, ECMO was stopped. On the 11 th day of admission, CT scan of the lungs revealed significant reduction of ground-glass opacities and consolidations. After about 2 wk, the patient recovered completely from ARDS and was discharged to home. At the 2-mo follow-up, the patient was in good health with no recurrence of dyspnea nor chest tightness. CONCLUSION ARDS complication caused by multiple wasp stings may be fatal when mechanical ventilation becomes dangerous due to persistent hypoxemia and despite optimization of ARDS management. We propose that the early implementation of ECMO is a relatively effective treatment, although the evidence is relatively limited.

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Section: Discussionmentioning

confidence: 99%

Acute respiratory distress syndrome following multiple wasp stings treated with extracorporeal membrane oxygenation: A case report

Cai¹,

Xu²,

Zhang³

et al. 2022

World J Clin Cases

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“…Although wasp stings are common, serious clinical conditions appear to be underreported. [3][4][5][6][7] Wasp venoms are responsible for serious medical conditions. Components of wasp venoms are well documented and include allergens, enzymes, bioactive peptides, and amine substances that in general can act on the circulatory, immune, and nervous systems of their predators or an individual that causes them potential danger.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Late-Onset Pneumonitis after Apoica pallida (Insecta: Hymenoptera) Sting with Anaphylactic Reaction in the Brazilian Amazon

João

Bessa

Araújo

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Hymenopteran venoms, inoculated during stings by ants, bees, and wasps, are the most frequent cause of an IgE-mediated systemic hypersensitivity reaction in adults, which is a key process in drastic manifestations of anaphylaxis. Respiratory involvement is usually caused by pulmonary edema but is rarely described as including interstitial pneumonitis or acute respiratory distress syndrome. Here, we describe a case of severe allergic reaction after a sting by Apoica pallens with late-onset pulmonary involvement, including signs of vasoplegia (pleural effusion) and interstitial pneumonitis with mild rhabdomyolysis. The presence of late onset of pulmonary involvement after a severe allergic reaction after a sting by A. pallens shows the importance of keeping a patient with severe reactions under medical care for a minimum of 5 days to avoid serious late complications outside the hospital environment.

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2021

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Bee sting envenomation severe cases in Manaus, Brazilian Amazon: clinical characteristics and immune markers of case reports

Cited by 4 publications

References 11 publications

Acute respiratory distress syndrome following multiple wasp stings treated with extracorporeal membrane oxygenation: A case report

Acute respiratory distress syndrome following multiple wasp stings treated with extracorporeal membrane oxygenation: A case report

Case Report: Late-Onset Pneumonitis after Apoica pallida (Insecta: Hymenoptera) Sting with Anaphylactic Reaction in the Brazilian Amazon

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