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Ruwanpathirana P, Priyankara D. Clinical manifestations of wasp stings: a case report and a review of literature. Trop Med Health 2022; 50:82. [PMID: 36307881 PMCID: PMC9615201 DOI: 10.1186/s41182-022-00475-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Wasp stinging, a neglected tropical entity can have a myriad of local and systemic effects. We present a case of multi-organ injury following multiple wasp stings and a review of literature on the systemic manifestations of wasp stings.
Case presentation A 48-year-old Sri Lankan male who suffered multiple wasp stings, developed an anaphylactic shock with respiratory failure, which was treated with adrenaline and mechanical ventilation. Within the next 2 days the patient developed acute fulminant hepatitis, stage III acute kidney injury, rhabdomyolysis, haemolysis and thrombocytopenia. The patient was treated in the intensive care unit with ionopressors and continuous renal replacement therapy (CRRT). Haemoadsorbant therapy was used in adjunct with CRRT. There was a gradual recovery of the organ functions over the 1st week. However, the patient succumbed to fungal sepsis on the 16th day despite treatment. We conducted a literature review to identify the various clinical manifestations of wasp stinging. Wasp venom contains enzymes, amines, peptides and other compounds. These proteins can cause type 1 hypersensitive reactions ranging from local skin irritation to anaphylactic shock. Furthermore, the toxins can cause direct organ injury or delayed hypersensitivity reactions. The commonly affected organs are the kidneys, liver, and muscles. The effect on the haematological system manifests as coagulopathy and/or cytopenia. The heart, nervous system, lungs, intestines and skin can be affected rarely. Treatment is mainly supportive. Conclusion In conclusion, wasp envenomation can result in multi-organ injury and attention should be paid in doing further research and establishing evidence-based treatment practices.
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Affiliation(s)
- Pramith Ruwanpathirana
- Medical Intensive Unit, National Hospital Sri Lanka, 435/11, Thimbirigasyaya Road, Colombo 05, Sri Lanka.
| | - Dilshan Priyankara
- Medical Intensive Unit, National Hospital Sri Lanka, 435/11, Thimbirigasyaya Road, Colombo 05, Sri Lanka
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Prasad SK, Mehta SK, Satyanarayan B, Panda SK. Multi-organ dysfunction following honeybee bite-A rare entity. J Family Med Prim Care 2020; 9:5052-5054. [PMID: 33209844 PMCID: PMC7652159 DOI: 10.4103/jfmpc.jfmpc_629_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/10/2020] [Accepted: 06/25/2020] [Indexed: 11/06/2022] Open
Abstract
Honeybee bites have been known to cause localized allergic reactions and anaphylaxis but systemic toxic reactions leading to multiorgan dysfunction is very rare. Serious complications like acute renal failure, acute myocardial infarction (Kounis syndrome) and even death have been reported as the complication of honeybee bite. Herein, we report a case of multiorgan dysfunction following honeybee bite, which was complicated with acute kidney injury, thrombocytopenia, bradycardia, keratitis, and deranged liver function along with localized allergic reaction and pain.
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Affiliation(s)
- Satish Kumar Prasad
- M.D. Medicine, Senior Consultant, Consultant, Tata Main Hospital, Jamshedpur, Jharkhand, India
| | - Sameer Kumar Mehta
- M.D. Medicine, Specialist, Consultant, Tata Main Hospital, Jamshedpur, Jharkhand, India
| | | | - Suman Kumar Panda
- M.D. Medicine, Consultant, Tata Main Hospital, Jamshedpur, Jharkhand, India
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Shen L, Lee JH, Joo JC, Park SJ, Song YS. Bee Venom Acupuncture for Shoulder Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Pharmacopuncture 2020; 23:44-53. [PMID: 32685232 PMCID: PMC7338706 DOI: 10.3831/kpi.2020.23.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/29/2020] [Accepted: 05/18/2020] [Indexed: 12/31/2022] Open
Abstract
Objectives Our review aimed to summarize and evaluate evidence on the effectiveness of
bee venom acupuncture (BVA) in the treatment of shoulder pain. Methods Randomized controlled trials (RCTs) evaluating the effectiveness of BVA on
shoulder pain were searched up to October 2019 in 11 electronic databases
(Medline, Embase, CENTRAL, CiNii, CNKI, VIP, Wanfang, Kmbase, NDSL, RISS,
OASIS). The methodological quality of the included RCTs were evaluated using
Cochrane Risk of Bias tool and a meta-analysis was performed. Results Seven studies were included in the review, and four studies were included in
the meta-analysis. Comparing BVA plus conventional therapy (CT) with saline
injection plus CT, it showed an effect in favor of BVA plus CT in visual
analog scale (VAS) and pain rating scale (PRS) (p = 0.02, p = 0.009,
respectively). Comparing BVA plus physiotherapy (PT) with saline injection
plus PT, it showed that there was no significant difference in VAS and
verbal rating scale (VRS) between the two groups. Conclusion This systematic review and meta-analysis suggest that BVA could be beneficial
as an adjuvant treatment for shoulder pain.
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Affiliation(s)
- Lei Shen
- Department of Constitutional Medicine, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Jong Ha Lee
- Department of Korean Medicine Graduate School of Wonkwang University, Iksan 54538, Republic of Korea
| | - Jong Cheon Joo
- Department of Constitutional Medicine, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Soo Jung Park
- Department of Sasang Constitutional Medicine, College of Korean Medicine, Woosuk University, Jeonju 55338, Republic of Korea
| | - Yung Sun Song
- Department of Rehabilitation Medicine, College of Korean Medicine, Wonkwang University, Iksan 54538, Korea
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Cherniack EP, Govorushko S. To bee or not to bee: The potential efficacy and safety of bee venom acupuncture in humans. Toxicon 2018; 154:74-78. [PMID: 30268393 DOI: 10.1016/j.toxicon.2018.09.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/04/2018] [Accepted: 09/26/2018] [Indexed: 02/07/2023]
Abstract
Bee venom acupuncture is a form of acupuncture in which bee venom is applied to the tips of acupuncture needles, stingers are extracted from bees, or bees are held with an instrument exposing the stinger, and applied to acupoints on the skin. Bee venom is a complex substance consisting of multiple anti-inflammatory compounds such as melittin, adolapin, apamin. Other substances such as phospholipase A2 can be anti-inflammatory in low concentrations and pro-inflammatory in others. However, bee venom also contains proinflammatory substances, melittin, mast cell degranulation peptide 401, and histamine. Nevertheless, in small studies, bee venom acupuncture has been used in man to successfully treat a number of musculoskeletal diseases such as lumbar disc disease, osteoarthritis of the knee, rheumatoid arthritis, adhesive capsulitis, and lateral epicondylitis. Bee venom acupuncture can also alleviate neurological conditions, including peripheral neuropathies, stroke and Parkinson's Disease. The treatment has even been piloted in one series to alleviate depression. An important concern is the safety of bee venom. Bee venom can cause anaphylaxis, and several deaths have been reported in patients who successfully received the therapy prior to the adverse event. While the incidence of adverse events is unknown, the number of published reports of toxicity is small. Refining bee venom to remove harmful substances may potentially limit its toxicity. New uses for bee venom acupuncture may also be considered.
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Affiliation(s)
- E Paul Cherniack
- Division of Geriatrics and Palliative Medicine, University of Miami Miller School of Medicine, Miami VA Medical Center, Miami, USA.
| | - Sergey Govorushko
- Pacific Geographic Institute, Russian Academy of Sciences, Vladivostok, Russia; Far Eastern Federal University, Vladivostok, Russia
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Seo YJ, Jeong YS, Park HS, Park SW, Choi JY, Jung KJ, Lim JY. Late-Onset Post-radiation Lymphedema Provoked by Bee Venom Therapy: A Case Report. Ann Rehabil Med 2018; 42:626-629. [PMID: 30180534 PMCID: PMC6129717 DOI: 10.5535/arm.2018.42.4.626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/11/2017] [Indexed: 11/20/2022] Open
Abstract
Lymphedema is a common complication associated with cancer itself or with cancer treatment. Lymphedema infrequently occurs after drug therapy. Bee venom is one of the materials used in acupuncture, and it has been used in the treatment of a variety of inflammatory diseases including arthritis. We report a 74-year-old male patient with late-onset post-radiation lymphedema provoked by bee venom therapy. He was free of lymphedema for 5 years after the complete remission of prostate cancer which had been treated with transurethral resection and radiation therapy. The patient developed left leg swelling after undergoing bee venom therapy for left hip pain. Computed tomography and lymphoscintigraphy showed lymphedema without tumor recurrence or infection. The lymphatic system was suspected to be injured by bee venom therapy and lymphedema was provoked. Bee venom therapy should be used cautiously in patients prone to lymphedema.
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Affiliation(s)
- Young Jae Seo
- Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Yong Sung Jeong
- Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Hyo Sik Park
- Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Shin Who Park
- Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Ja Young Choi
- Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Kang Jae Jung
- Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Jong Youb Lim
- Department of Rehabilitation Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
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Hamad MK, He K, Abdulrazeq HF, Mustafa AM, Luceri R, Kamal N, Ali M, Nakhla J, Herzallah MM, Mammis A. Potential Uses of Isolated Toxin Peptides in Neuropathic Pain Relief: A Literature Review. World Neurosurg 2018; 113:333-347.e5. [DOI: 10.1016/j.wneu.2018.01.116] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 01/31/2023]
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Bellanger RA, Seeger CM, Smith HE. Safety of Complementary and Alternative Medicine (CAM) Treatments and Practices. SIDE EFFECTS OF DRUGS ANNUAL 2017. [DOI: 10.1016/bs.seda.2017.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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