Giant Asian honeybee or Bambara stings causing myocardial infarction, bowel gangrene and fatal anaphylaxis in Sri Lanka: a case series

Budagoda, B D Sudhara S; Kodikara, K.A.S.; Kularatne, W. K. S.; Mudiyanse, RM; Edussuriya, DH; Edirisinghe, Jayanthi P.; Karunaratne, W. A. I. P.; Weerakoon, Kosala; Medagedara, Senal; Kularatne, S.A.M.

doi:10.1016/s1995-7645(10)60143-5

Cited by 17 publications

(19 citation statements)

References 5 publications

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“…Stinging attacks by bees and wasps on humans have become a common occurrence in Sri Lanka. [1][2][3] In 2014, a fatal sting from a flying insect in Puttalam in the North Western Province of Sri Lanka gained much publicity in the local media. This incident, reported in the local newspapers and social media, prompted us to find the offending insect that was killed by the victim's companion.…”

Section: Introductionmentioning

confidence: 99%

First Reported Case of Fatal Stinging by the Large Carpenter Bee Xylocopa tranquebarica

Kularatne¹,

Sathasivam²,

Edirisinghe

et al. 2016

Wilderness & Environmental Medicine

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In the order Hymenoptera, bees, hornets, and wasps are well-known stinging insects whose envenoming can be fatal. Their stinging attacks are common in rural and forested areas of Sri Lanka. However, fatal stinging by the large-bodied carpenter bees is unreported. We report the first known case of a fatal sting by the large carpenter bee, Xylocopa tranquebarica, in a forested area in Puttalam (North Western Province) in the dry zone of Sri Lanka. A 59-year-old healthy male manual laborer accompanied by a fellow worker had been fixing a fence on a coconut estate bordering a forested area when a flying insect emerged from a dead tree trunk and stung him on his face. His coworker, who was watching the incident, killed the insect. The victim complained of immediate intense pain in the face and collapsed on the ground just after resuming work after 10 minutes of resting. He was found dead on admission to the hospital 90 minutes later. Autopsy showed normal coronary arteries and heart, but the lungs were slightly congested and contained secretions in the bronchi. Acute anaphylaxis was the most likely cause of death. This case presents the habitat, morphology, attack pattern, and the medical importance of large carpenter bees.

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Section: Introductionmentioning

confidence: 99%

First Reported Case of Fatal Stinging by the Large Carpenter Bee Xylocopa tranquebarica

Kularatne¹,

Sathasivam²,

Edirisinghe

et al. 2016

Wilderness & Environmental Medicine

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“…Sinhala names for Apis dorsata, Vespa tropica, and Ropalidia marginata are ''Bambara'', ''Debara'' and ''Kaladuruwa'' respectively. A worker giant Asian honeybee is approximately 17-20 mm long and has a hair covered body [14]. The length of Vespa tropica female is 19-30 mm with a large, stout body covered with strong, stiff hairs and the second gastraltergite (2nd dorsal shield of the abdomen) is yellow with a slight brown area basally [17].…”

Section: Resultsmentioning

confidence: 99%

“…Multi organ failure, rhabdomyolysis, electrocardiographic changes, acute kidney injury and myocardial infarction are well known complications of mass envenomation due to hymenoptera sting [8][9][10][11]. There are reports of acute kidney injury, myocardial infarction, severe anaphylaxis and bowel gangrene after giant Asian honeybee or wasp sting in Sri Lanka [8,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…But a single wasp is capable of stinging multiple times as the stinger is not separated from the body after sting. This finding is useful to differentiate honeybee from wasp as wasps do not leave the stinger on the victim's skin [14]. Venom glands of hymenopterans produce a variety of toxic substances including active amines (serotonin, histamine, tyramine, catecholamines), wasp kinins (similar in composition to bradykinins) and histaminereleasing peptides [9].…”

Section: Introductionmentioning

confidence: 99%

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Bee and wasp stings in Deniyaya; a series of 322 cases

Witharana¹,

Wijesinghe²,

Pradeepa³

et al. 2015

Ceylon Med. J.

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“…Apis dorsata sting can cause a spectrum of clinical manifestations ranging from local allergic reactions to mass envenomation and end-organ damage. There are reports of acute kidney injury, myocardial infarction, severe anaphylaxis and bowel gangrene after giant honeybee or wasp sting in Sri Lanka [ 2 – 5 ]. Acute lower limb ischaemia due to possible vasoconstriction and multi-organ failure following wasp sting in Sri Lanka is also reported [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Giant honey bee (Apis dorsata) sting and acute limb ischemia: a case report and review of the literature

Ratnayake¹,

Weerathunga²,

Dilrukshi³

et al. 2018

BMC Res Notes

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BackgroundClinically significant manifestations of Hymenopteran envenomation is increasingly recognized in Sri Lanka. These clinical manifestations range from localized allergic reactions to end-organ failure and thrombotic-episodes. We report a case of 65 year old male who developed acute lower limb ischaemia after a sting of the hymenopteran Apis dorsata.Case presentationA 65 year old male with hypertension and hyperlipidaemia presented with envenomation from an attack of a swarm of A. dorsata. He subsequently developed acute limb ischaemia following an acute femoral thrombus and made a complete recovery with anticoagulation and surgical-embolectomy.ConclusionsThis case adds to the spectrum of thrombotic manifestations of Hymenopteran venom highlighting the requirement for close monitoring and clinical vigilance in these patients.

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Giant Asian honeybee or Bambara stings causing myocardial infarction, bowel gangrene and fatal anaphylaxis in Sri Lanka: a case series

Cited by 17 publications

References 5 publications

First Reported Case of Fatal Stinging by the Large Carpenter Bee Xylocopa tranquebarica

First Reported Case of Fatal Stinging by the Large Carpenter Bee Xylocopa tranquebarica

Bee and wasp stings in Deniyaya; a series of 322 cases

Giant honey bee (Apis dorsata) sting and acute limb ischemia: a case report and review of the literature

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