Africanized honeybee stings: how to treat them

Author(s)

Monteiro de Barros Almeida, Ricardo Augusto ^[1] ; Toscano Olivo, Taylor Endrigo ^[1] ; Mendes, Rinaldo Poncio ^[1] ; Catharino Sartori Barraviera, Silvia Regina ^[2] ; Souza, Lenice do Rosario ^[1] ; Martins, Joelma Goncalves ^[3] ; Hashimoto, Miriam ^[3] ; Fabris, Viciany Erique ^[4] ; Ferreira Junior, Rui Seabra ^[5] ; Barraviera, Benedito ^{[5, 1]}

Affiliation

^[1] Univ Estadual Paulista, Dept Doencas Trop & Diagnost Imagem, Fac Med Botucatu, Botucatu, SP - Brazil

^[2] Univ Estadual Paulista, Dept Dermatol & Radioterapia, Fac Med Botucatu, Botucatu, SP - Brazil

^[3] Univ Estadual Paulista, Dept Pediat, Fac Med Botucatu, Botucatu, SP - Brazil

^[4] Univ Estadual Paulista, Dept Patol, Fac Med Botucatu, Botucatu, SP - Brazil

^[5] Univ Estadual Paulista, Ctr Estudos Venenos & Anim Peconhentos, Botucatu, SP - Brazil

• Document type: Journal article
• Source: Revista da Sociedade Brasileira de Medicina Tropical; v. 44, n. 6, p. 755-761, NOV-DEC 2011.
• Web of Science Citations: 15

Abstract

INTRODUCTION: In 1956, Africanized honeybees (AHB) migrated from Brazil to other regions of the Western Hemisphere, including South, Central, and North America, except for Canada. Despite being productive, they are highly aggressive and cause fatal accidents. This study aimed to evaluate patients at the Clinical Hospital of Botucatu Medical School (HC-FMB) and to propose treatment guidelines. METHODS: From 2005 to 2006, the clinical and laboratorial aspects of 11 patients (7 male and 4 female) and the anatomopathological aspects of one patient who had died in 2003 were analyzed. RESULTS: The age of the surviving patients varied from 5 to 87 years, with a mean of 42.5 years. The majority of accidents occurred in the afternoon, and the number of stings ranged from 20 to 500. The principal signs and symptoms were pain and local inflammatory signs, nausea, tachycardia, and vomiting. Biochemical findings presented increased levels of creatine phosphokinase, lactate dehydrogenase, and aspartate/alanine aminotransferase. An 11-year-old male patient died upon entering the attic of a two-storey building where he was attacked by a swarm, receiving more than 1,000 stings. He was sent to HC-FMB where he was treated, but he died 24h later. Observed at the autopsy were erythematous-purpuric skin lesions besides necrosis at the sting locations, rhabdomyolysis, focal myocardial necrosis, tubular hydropic degeneration and focal tubular acute necrosis of the kidneys, myoglobinuria, and centrolobular necrosis in the liver. CONCLUSIONS: Accidents caused by multiple AHB stings always constitute a medical emergency. As there is no specific antivenom, we have developed guidelines, including first aid, drugs, and the proper removal of stingers. (AU)

• FAPESP's process: 07/05159-7 - Isolation of coagulant serine-proteases from Bothrops neuwiedi pauloensis and Crotalus durissus terrificus venoms: functional and structural characterization
• Grantee: Benedito Barraviera
• Support Opportunities: Regular Research Grants