Severe acute renal failure after massive attack of Africanized bees

Ponce, Daniela; Rodrigues, Antonio Gonçalves; Barsante, Renata Cristina; Silva, Vanessa dos Santos; Júnior, João Garcia Caramori; Martim, Luís Cuadrado; Barretti, Pasqual; Balbi, André Luís

doi:10.1093/ndt/gfh440

Cited by 28 publications

(11 citation statements)

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“…This type of accident is followed by complications such as hypotension, hemolysis, rhabdomyolysis, clotting disturbances, and hepatic involvement 34,52 . According to Gabriel et al 53 , four hypotheses must be considered to explain the pathogenesis of acute tubular necrosis: I) a direct toxic effect of AHB venom on renal tubules, especially proximal tubules; II) a toxic effect of myoglobin and hemoglobin on the tubules ( Figure 1E); III) an ischemic effect mediated by AHB or by substances released in the organism, or by a fall in cardiac output due to acute myocardial infarction-like lesions with a consequent fall in mean arterial pressure, reducing renal plasma flow; and iv) a stress-potentiating effect acting, for example, on nicotinamide adenine dinucleotide release in the myocardium, aggravating the cardiac ischemic component and consequently renal perfusion.…”

Section: Anatomopathological Examinationmentioning

confidence: 99%

Africanized honeybee stings: how to treat them

Almeida

Olivo

Mendes

et al. 2011

Rev. Soc. Bras. Med. Trop.

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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.

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Section: Anatomopathological Examinationmentioning

confidence: 99%

Africanized honeybee stings: how to treat them

Almeida

Olivo

Mendes

et al. 2011

Rev. Soc. Bras. Med. Trop.

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“…The apamine is neurotoxic [1]- [5]. The attacks in urban areas as in our case are rare; it is often occurred most of times in rural areas [6]. The severity of the clinical picture of our patient is due on the one hand to the location of the stings in the head end and to the extension to the entire skin surface and on the other hand to his young age.…”

Section: Commentsmentioning

confidence: 57%

Massive Envenomation by Bees Sting in a Child in Togo

Akolly¹,

Guedenon²,

Tsolenyanu³

et al. 2016

OJPed

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Attacks by swarm of bees realize arrays of mass poisoning. We report the case of a 9 years old boy whoes severity was related to the large number of bees which was about 400 and their locations spread throughout the skin surface with a preponderance to the cephalic end. Complications were hemolytic anemia, kidney failure and convulsions. The outcome was favorable with symptomatic care and hemodialysis.

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“…Envenomed patients commonly have anuria or oliguria, high levels of serum creatinine (10-30 mg/dL) and CK (>2,000 U/L), hypotension, tachycardia, myocardial damage and anemia (Daher et al, 2003;Gabriel et al, 2004;França et al, 1994;Xuan et al, 2010). Acute tubular necrosis is the main histologic finding in human beings, domestic dogs, and in experimental animals after bee and wasp envenomations.…”

Section: Bee and Wasp Envenomationmentioning

confidence: 99%