Bee stings of children: when to perform endotracheal intubation?

Tome, Riad; Somri, Mostafa; Teszler, Christian B.; Fradis, Milo; Gaitini, Luis

doi:10.1016/j.amjoto.2005.01.002

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…18 The administration of antihistamines and corticosteroids is a mainstay of therapy to reduce the local inflammation caused by venomous insect stings, but in cases of significant upper airway edema, the addition of epinephrine may also be necessary. 19,20 Additionally, after complete recovery, in vivo and in vitro diagnostic testing with skin tests utilizing hymenoptera venom extracts and analysis of serum for hymenoptera venom-specific IgE should be performed. 21 Large local reactions to hymenoptera venom can be caused by both IgE-mediated or cell-mediated allergic mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Critical Upper Airway Edema After a Bee Sting to the Uvula

Singer

Lande

2022

Wilderness & Environmental Medicine

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Hymenoptera stings of the upper airway are rare events, but can result in rapid, life-threatening airway emergencies. The allergenic and toxic mediators that are released from the stings of bees, wasps, and hornets can cause local tissue inflammation and edema with subsequent upper airway obstruction. We report the case of a 15-y-old girl who suffered a bee sting to the uvula while zip-lining in Costa Rica. Shortly thereafter, she developed a choking sensation with associated dysphonia, odynophagia, drooling, and respiratory distress. She was brought to a rural emergency medical clinic where she was noted to have an erythematous, edematous, boggy uvula, with a black stinger lodged within it, as well as edema of the anterior pillars of the tonsils and soft palate. The stinger was removed with tweezers and she was treated with an intravenous corticosteroid and antihistamine. She had persistence of airway edema and symptoms until the administration of epinephrine, which resulted in clinical improvement shortly thereafter. In our review of this case and the existing literature, we emphasize the importance of early recognition and management of hymenoptera stings of the upper airway, which should always include immediate manual removal of the stinger, and in cases with significant upper airway edema, the administration of epinephrine should be considered.

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Section: Discussionmentioning

confidence: 99%

Critical Upper Airway Edema After a Bee Sting to the Uvula

Singer

Lande

2022

Wilderness & Environmental Medicine

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“…A mild systemic reaction consisting of urticaria, erythema, nausea or diarrhea; and 4. A severe systemic reaction including laryngeal edema, bronchospasm and hypotension (3). Symptoms following bee stings may be due to immediate or delayed reactions.…”

Section: Floor Of the Nose Mucosa Lysis And Labial Abscessmentioning

confidence: 99%

Floor of the nose mucosa lysis and labial abscess caused by a bee sting

et al. 2009

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Hymenoptera order includes bees, which have a stinging apparatus at the tail capable of delivering venom to the affected tissues. Myocardial infarction, acute renal failure, Necrotizing fasciitis, fatal infection and hemifacial asymmetry, are some of the unusual reactions reported following hymenoptera stings. This paper reports a case of bee sting in the right floor of the nose that mimicked an odontogenic infection affecting the upper lip, canine space and nasal cavity such as in cases of infection secondary to pulpal or periodontal pathology of the anterior teeth. After a thorough clinical and radiographic examination, odontogenic infection was discarded and the diagnosis of floor of the nose mucosal lysis and lip abscess secondary to a bee sting was made. This case was successfully managed with adequate incision, drainage and antibiotics without any further complication. There are several reports of unusual reactions following hymenoptera stings. However, just a few of them referred to infections of local reactions and none of them related to the anatomic location affected in the patient of the present case. Early diagnosis and treatment prevented infection dissemination and the likelihood of tissue necrosis as in previously reported cases of Necrotizing fasciitis.

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“…Il trattamento farmacologico varia in base alla clinico e, comunque, deve sempre essere attuato prontamente, nei casi di anafilassi sistemica con coinvolgimento di almeno due apparati, con adrenalina 3 e, nelle punture a rischio elencate in precedenza, con corticosteroidi e antistaminici. Le punture nel cavo orale richiedono una cura particolare in quanto anche un edema banale può compromettere la fisiologica funzionalità respiratoria; maggiore attenzione va poi posta ai soggetti in età pediatrica, nei quali il ridotto calibro tracheale può richiedere l'intubazione orotracheale preventiva 4 . Fra le lesioni indotte da questa classe di insetti, oltre all'anafilassi e alle punture multiple, è ancora necessario ricordare l'artropatia da punture di imenotteri, che si manifesta come un'artrite in forma acuta o in forma ritardata, elettivamente successiva a punture d'ape.…”

Section: S S I I N N T T E E S S I Iunclassified

Injuries caused by arthropods: diagnostic and therapeutic approach in ER

Moreno

Lauria

2009

Emerg Care J

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I In nt tr ro od du uz zi io on ne e L'entomologia medica in Italia rappresenta una branca delle scienze entomologiche particolarmente negletta che anche presso i corsi di laurea in medicina trova poco spazio. Ciò nonostante gli accessi DEA e le richieste presso gli ambulatori dei medici di medicina generale per incidenti correlati o correlabili a insetti o aracnidi, in particolare nei mesi estivi, non mancano mai anche nel nostro "bel paese", che ha il pregio di non avere specie animali particolarmente pericolose. Sia presso i DEA che presso i medici di base gli incidenti da artropodi pongono molte volte dei formidabili quesiti diagnostici, terapeutici ed educativi (educazione sanitaria) in quanto sussistono svariate difficoltà, quali: 1) identificazione corretta dell'agente lesivo; 2) formulazione di una corretta

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Bee stings of children: when to perform endotracheal intubation?

Cited by 3 publications

References 7 publications

Critical Upper Airway Edema After a Bee Sting to the Uvula

Critical Upper Airway Edema After a Bee Sting to the Uvula

Floor of the nose mucosa lysis and labial abscess caused by a bee sting

Injuries caused by arthropods: diagnostic and therapeutic approach in ER

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