Myocardial infarction following a bee sting: A case report of Kounis syndrome

Abstract

In this case report study a 41-year-old man envenomed by a bee sting and diagnosed as Kounis syndrome secondary to hymenoptera envenomation. The patient developed a typical course of myocardial infarction, but the electrocardiogram changes were reversed to almost normal limits. He had a nonsignificant mild lesion in the proximal port of right coronary artery in coronary angiography. The case recovered and discharged after 6 days hospitalization. The clinical implications and pathophysiology of this dangerous association are discussed.

Kounis syndrome induced by contrast media: A case report and review of literature

“…The actual etiology of KS is still unclear. Antibiotics are the most frequent triggers [3,[13], [14], [15]], although insect bites [[16], [17], [18]], anticancer drugs [[19], [20], [21], [22], [23]], bee stings [[24], [25], [26], [27], [28]], and anesthetics [29,30] have also been reported to be causative factors. Despite its rare incidence, improvement in awareness of KS among physicians might have led to the recent increase in case reports related to KS.…”

Infarto del miocardio por picadura de abejas

“…El segundo mecanismo fisiopatológico que explica el compromiso cardiaco por picadura de abejas es la lesión miocárdica directa por las toxinas del veneno, que a diferencia de las respuestas mediadas inmunológicamente tiene una relación dosis efecto; de hecho, ya se conoce la dosis letal 50 del veneno de abejas que corresponde a 1500 picaduras en un individuo de 75 kg o menos (5). Citotóxicos directos como la melitina producen lisis celular capaz de elevar los niveles sanguíneos de troponinas y así comprometer la función cardiaca como lo hacen otras sustancias orgánicas o inorgánicas descritas en la literatura, pero que por la rareza de los casos de ataques masivos no ha sido aclarado el efecto cardiaco de este tipo de veneno en humanos y la evidencia se limita a los datos que ofrecen modelos animales.…”

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

“…A rare effect promoted is myocardial infarction, which usually occurs after multiple honeybee stings ( 35 – 38 ), but has also been observed as a result of only one sting ( 39 ). It is likely that myocardial infarction is caused by the spasm or thrombosis of the coronary arteries ( 39 , 40 ) or is secondary to the hypersensitivity reaction ( 38 ).…”