An unusual neurological consequence of massive wasp stings

Abstract

Although rare, central and peripheral neurological manifestations after single or multiple wasp stings have been reported. The authors describe a 45-year-old man who developed periods of sudden loss of consciousness with a Glasgow Coma Scale of 6 after being stung by fifty wasps. These periods were seen directly after being stung and were continuing months later. Different mechanisms and pathophysiological findings of neurological sequela reported after wasp stings are being reviewed.

Bee-sting with Extensive Cerebral Infarct: A Case Report

“…A possible additional benefit of steroid use in our patient is the resolution of the cerebral oedema. There have been other reports of improvement following steroid use among victims of bee sting that had CNS affectation [11,14]. Most of such reported cases had a complete recovery, however, the features of extensive brain infarct that we saw in our patient may imply an enduring neurological deficit.…”

“…Several pathways have been suggested to explain the effect of the bee venom on the CNS. One of such explanations is the hypoxic-ischaemic mechanism [11]. The venom contains vasoactive, inflammatory and thrombogenic peptides and amines, including leukotrienes and thromboxanes [11].…”

“…One of such explanations is the hypoxic-ischaemic mechanism [11]. The venom contains vasoactive, inflammatory and thrombogenic peptides and amines, including leukotrienes and thromboxanes [11]. Cerebral infarction following bee sting may thus be caused by vasoconstriction and platelet aggregation initiated by these vasoactive compounds.…”

Multi-organ dysfunction secondary to severe wasp envenomation

“…Together, they are responsible for the myriad presentation of wasp sting. The more severe systemic complications include renal (acute renal failure, nephrotic syndrome, and renal tubular acidosis) [ 11 , 12 ], cardiac (myocarditis, myocardial infarction, and arrhythmias) [ 13 , 14 ], hepatic (centrilobular necrosis and pericholangitis) [ 15 , 16 ], neurological (stroke, Guillian-Barre syndrome, and acute encephalopathy) [ 17 , 18 ], hematological (hemolysis, DIC, and thrombocytopenia) [ 19 - 21 ], and vasculitis [ 22 ]. Our patient had several of these systemic reactions.…”