A Call for sting treatment protocol: Case report of a 3 year old with massive bee sting resulting in acute kidney injury

Abstract

Acute Kidney Injury in children following bee sting envenomation is rare and survival is hinged on early recognition and prompt appropriate management. This report is aimed at raising awareness among healthcare workers, of one of the systemic effects of massive bee sting and the need to develop sting treatment protocol. A three year old preschooler was attacked by a swarm of bees, receiving over 150stings. Initial clinical features were allergic response involving the head, face and tongue for which he had first aid in a primary healthcare facility and thereafter sent home. Few hours later he developed clinical features of intravascular haemolysis, rhabdomyolysis, hypertension and acute renal failure. Laboratory findings were in keeping with clinical presentation. Despite supportive management, serum biochemistry worsened necessitating haemodialysis. Massive bee sting envenomation can cause systemic reactions and organ dysfunctions. To improve the overall clinical outcome, sting treatment protocol is advocated.

Altered Serum Metabolite Profiling and Relevant Pathway Analysis in Rats Stimulated by Honeybee Venom: New Insight into Allergy to Honeybee Venom

“…26 Many studies in recent years have focused on the reasons, 27 prevalence, 6 pathological mechanism, 28 and treatment of honeybee venom stimulation. 3 Although some studies have yielded knowledge about the complex response of an organism to honeybee venom stimulation, the exact mechanism of response has still not been fully explained. Moreover, there is virtually no or very little literature about the effect of honeybee venom at the metabolic level, especially the changes at different time points.…”

“…According to European and American population-based studies, the lifetime occurrence of a systemic reaction to honeybee venom ranges from 0.3 to 7.5% in adults and depends upon various factors, such as geography, study population, venom used for diagnosis, and the profession and hobbies of the subject . Studies have shown that honeybee venom administration could stimulate the function of the immune system and affect the release of cortisol production, which is known as a natural anti-inflammatory agent . The typical reaction of one organism to honeybee venom ranges from a smaller local reaction to a larger effect, with the most serious circumstance leading to anaphylaxis and death .…”

Acute kidney injury in a Tanzanian boy following multiple bee stings in resource-limited setting: a case report

“…AKI in children after bee sting has been reported elsewhere [ 8 ]. Bee sting leaves stings behind which release venom amounting to 50–140 µg/sting which is a large dose enough to cause systemic damage [ 2 , 9 ].…”

“…Both hemodialysis and peritoneal dialysis have been used to treat AKI following multiple bee sting effectively with good outcomes [ 2 , 4 , 5 , 8 , 9 , 11 ]. Although dialysis does not clear the bee venom, maintenance of good hydration and urine output are necessary in management of bee sting venom.…”

“…AKI in children following multiple bee stings is uncommon complication in Africa and there is limited literature, especially in children. Also there is no treatment protocol that can be initiated promptly at all levels of health care services [ 8 , 9 ]. In this case report, we will describe a case of AKI following multiple bee stings in peadiatric and resource-limited setting.…”