2018
DOI: 10.1590/0037-8682-0341-2017
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Abstract: Accidents related to Africanized honey bees are growing globally and are associated with multiple stings owing to the aggressive behavior of this species. The massive inoculation of venom causes skin necrosis and rhabdomyolysis leading to renal failure. Anaphylactic manifestations are more common and are treated using well-defined treatment protocols. However, bee venom-induced toxic reactions may be serious and require a different approach. We report the case of a 3-year-old child, which would help clinicians… Show more

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Cited by 15 publications
(8 citation statements)
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“…In this context, it is impossible to know whether death was caused by intoxication, as in the case of massive attack, or was due to anaphylaxis. However, the greater number of stings was directly related to higher morbidity, severity, and need for hospitalization 14,15 . It should be noted that late complications that evolved to death were not recorded to be a result of honey bee sting incidents.…”
Section: /6mentioning
confidence: 99%
“…In this context, it is impossible to know whether death was caused by intoxication, as in the case of massive attack, or was due to anaphylaxis. However, the greater number of stings was directly related to higher morbidity, severity, and need for hospitalization 14,15 . It should be noted that late complications that evolved to death were not recorded to be a result of honey bee sting incidents.…”
Section: /6mentioning
confidence: 99%
“…After aggressive fluid supplementation and timely hemodialysis, the oliguric AKI was corrected with recovery of renal function [8]. The direct toxicity of massive envenomation also promoted hepatitis [8,10]. Interestingly, venom toxicity that developed into ARDS has been rarely reported previously.…”
Section: Discussionmentioning
confidence: 99%
“…Massive envenomation, defined as a minimum of 50 stings, causes systemic toxicity due to the amount of venom inoculated, with an estimated lethal dose of 500-1,000 stings [5,7,9]. Bee venom is a complex mixture of amines and peptides, most notably mellitin, the main and most toxic compound and phospholipase A2, the most immunogenic peptide [2,7].…”
Section: Discussionmentioning
confidence: 99%
“…Initial symptoms of toxicity are often non-specific and may include weakness, myalgias, nausea, vomiting, and diarrhea which then evolve into hemolysis, hematuria, and AKI. Hematuria typically occurs within 24 hours of the envenoming incident followed by elevation of CK levels and clinical evidence of kidney injury within the next 48 hours [5,6]. Several case reports exist that describe patients being discharged after having been evaluated for multiple bee stings only to return hours later with symptoms consistent with envenoming syndrome requiring further intervention [5,12].…”
Section: Discussionmentioning
confidence: 99%
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