Stroke intracerebral multiple infarcts: Rare neurological presentation of honey bee bite

Abstract

Honey-bee bites which require urgent hospitalization is very rare. It is mainly seen as occupational hazards in farmers, tree dwellers and honey collectors. Common clinical presentation includes minor localized reactions in form of swelling and redness sometimes anaphylactic reaction. Infrequent major complications reported from different studies include rhabdomyolysis, acute renal failure (ARF), acute pulmonary edema, intravascular coagulation, encephalopathy and very rarely cerebral haemorrhage. Stroke due to multiple intra- cerebral infarcts along with rhabdomyolysis in patient of honey-bee bite is rare neurological complication. We report a case of 70 year man with honey-bee bite and multiple intracerebral infarcts presented as stroke, and rhabdomyolysis and ARF. When a patient presented with honey-bee bite, one should suspect serious complications. Despite advances in the understanding of pathophysiology its complications remains enigmatic and in some instances may be multifactorial. Various therapeutic interventions if started early after diagnosis reduces the possible consequences as potential reversibility of the illness.

Allergic Anaphylactic Risk in Farming Activities: A Systematic Review

“…From three articles, two describe respiratory symptoms in fruit harvesters (peaches) and hops. The third case, on the other hand, reports a particular situation, namely a beekeeper suffering from massive attack of a swarm of bees who is affected by sensory alteration, kidney failure and multiple brain infarcts [41]. In the two studies with farmworkers, the subjects were young, an average age of about 30 years, while in the third case report the beekeeper was older, about 70 years old.…”

“…In the two studies with farmworkers, the subjects were young, an average age of about 30 years, while in the third case report the beekeeper was older, about 70 years old. The first group exhibited symptoms mainly in the harvest phase and improved with a period of estrangement from work [41,42]. In Reeb, respiratory disease affected not only new workers employed for less than one year (23%) but also in employees with more than 20 years of experience working for their employer (9%) [43].…”

“…In Reeb, respiratory disease affected not only new workers employed for less than one year (23%) but also in employees with more than 20 years of experience working for their employer (9%) [43]. With regards to the beekeeper, the authors postulate that the tissue damage caused by toxins in honey bee venom (mellitin and phospholipase) induced disseminated intravascular coagulation (DIC), along with systemic anaphylatic reaction-induced hypotension with subsequent ischemia, which resulted in both stroke and renal failure [41].…”

Anaphylactic Shock

“…Neurologic changes are mostly secondary to hypotension and decreased perfusion and may manifest as dizziness, confusion, syncope/presyncope, or headache [50]. More serious effects including seizure and stroke may also be seen but are rare [74,79].…”

A Rare Case of Massive Envenomation of Honey Bees With Anaphylaxis

“…2 There are several reports from India and abroad, of patients developing rhabdomyolysis, acute renal failure, Guillain-Barre syndrome, myasthenia gravis and coagulopathy following multiple bee stings. [9][10][11][12] Kidney failure and cardio toxicity cause most toxic bee sting deaths.…”