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Purpose: To compare the outcomes of ocular injuries of hornets and paper wasps’ stings.Study design: Retrospective case series.Methods: Patients diagnosed with ocular injuries sustained by bee stings at Miyata Eye Hospital (Miyazaki, Japan) between August 2000 and July 2016 were enrolled. Retrospective data regarding type of bee, visual acuity, and treatment were collected from medical records. Outcomes of the hornet and wasp groups were compared.Results: Five eyes of 5 patients (3 men, 2 women; mean age 44.6±21.2 years [range 9-62 years]) were enrolled. The mean follow-up period was 50.6 ± 57.6 months (range 4 days to 121 months). The causative bee was hornet in 3 cases and wasp in 2. The anterior chamber was irrigated in 2 patients, both from the hornet group. The best-corrected visual acuity at the final visit was no light perception, light perception, and (0.02) in the hornet group, (1.5) and (1.2) in the wasp group.Conclusions: The hornet group exhibited significantly worse prognosis than the wasp group. Identifying the type of bee is important in establishing prognosis. [ABSTRACT FROM AUTHOR]

In South Africa bee stings are most commonly caused by either Apis mellifera capensis or A. mellifera scutellata, indigenous species which are notoriously aggressive when compared to European honey bees. According to Statistics South Africa, 109 deaths were documented for the period 2001-2011 as having been caused by hornets, wasps, and bees (ICD10-X26). This appears to be a small number but, as was reported in Australia, these statistics might be inaccurate due to either over- or underreporting of cases. We report 3 cases of fatalities due to bee stings, including one with postmortem features of diffuse intravascular coagulopathy. A brief overview of the venom of the honey bee, reactions following a bee sting and possible mechanisms of death are presented. Confirming the diagnosis in these cases may be very problematic for the forensic pathologist, as in many cases minimal history is available and both external and internal examination could fail to reveal any specific signs of bee sting or other obvious morphologic abnormalities. Thus, there is a need for reliable confirmatory or supportive diagnostic tests. [ABSTRACT FROM AUTHOR]

The article offers information on a survey related to the arrival of the dwarf honeybee, Apis florea in Djibouti; discusses its uncertain impact on agriculture, apiculture, and biodiversity conservation; and human health problem associated with accidental stings.

Necrotizing soft-tissue infections such as necrotizing fasciitis continue to have a high morbidity and mortality. More and more, these difficult cases are being referred to burn centers for specialized wound and critical care treatment. The case of a necrotizing soft-tissue infection after a honeybee sting is reported. To the best of our knowledge, it is the first documented case of necrotizing fasciitis caused by invasive group A Streptococcus from a bee sting. A 56-year-old man was stung by a bee in the left upper gluteal region. The sting was removed by the patient. Within hours, erythema, swelling, itching, and pain developed. On day 7, after the bee sting, the patient was admitted to a general surgery department with progressive skin and soft-tissue necrosis around the hip and the upper left leg. Because of the rapidly deteriorating condition, the patient was referred to our burn ICU with the picture of a progressive necrotizing fasciitis. The skin necrosis required immediate epifascial necrectomy. Additionally local therapy with topical antiseptics was performed. The surface was temporarily covered with xenograft, definitive coverage was achieved with autologuous skin graft transplantation. Advancements in wound care and critical care, which have become standard in the treatment protocols of patients with necrotizing soft-tissue infections, have markedly improved the prognosis. However, these infections continue to be a source of high morbidity and mortality and significant healthcare resource consumption. These challenging patients are best served with prompt diagnosis, immediate radical surgical debridement, and aggressive critical care management. Referral to a burn center may help to provide best possible surgical intervention, wound care, and critical care management. [ABSTRACT FROM AUTHOR]

This study was conducted to test for the effect of three stinging behaviors QTLs (sting-1, sting-2 and sting-3) on the expression of guarding and stinging behavior of individual honey bees, and to determine if results of defensive behavior QTLs found in studies with Africanized honey bees could be extended to other populations of bees. Samples of guards, stingers, foragers and nurse bees were taken from two backcross colonies derived from a defensive colony and a gentle colony. The genotype of each bee for both types of colonies was determined for two sequence tagged site (STS) markers linked to sting-1 and for another two STSs, one linked to sting-2 and one linked to sting-3. Results showed that sting-1 had an effect on the expression of both stinging and guarding behaviors, sting-2 and sting-3 influenced the expression of guarding behavior. These results indicate that division of labor is influenced by specific QTLs. Results also show that QTLs mapped in a population of Africanized honey bees using colony level phenotypes also influenced the expression of guarding and stinging behavior of individual bees of other populations. [ABSTRACT FROM AUTHOR]

Focuses on the importance of confocal microscopy in bee sting corneal injury. Possible consequence of retained bee sting in human eyes; Limitations of a slit lamp in the detection of foreign insect parts in the body.

Acute disseminated encephalomyelitis (ADEM) usually follows a viral infection or an immunization and is thought to be an immunomediated disease. We describe a patient with ADEM after multiple yellow jacket bee stings. The patient recovered after treatment with a high dose of methylprednisolone. Although the pathologic mechanism exact remains unclear, potential cross-reactivity between bee toxins and the central nervous system myelin could induce demyelination. ADEM should be considered a rare complication of bee stings. [ABSTRACT FROM AUTHOR]

Bee venom is a complex substance, which acts in several tissues. Although severe allergic reactions have occurred after one or more stings, several deaths have been reported without allergic manifestations, emphasizing the toxic effects of massive poisoning. A number of about 500 stings have been considered necessary to cause death by direct toxicity, but as few as 30–50 stings have proved fatal in children. Among the major toxic effects are hemolytic anemia, acute renal failure (ARF), and shock. ARF may be due to a common toxic-ischemic mechanism with hypovolemic or anaphylactic shock, pigment tubulopathy (myoglobinuria and hemoglobinuria), or acute tubular necrosis (ATN) from a direct kidney toxicity of the venom. We present a case of rhabdomyolysis and hemolysis with consequent ARF which developed after about 800 bee stings. The patient recovered completely after peritoneal dialysis. [ABSTRACT FROM AUTHOR]

The occurrence of nephrotic syndrome after an insect sting is rarely reported in the literature. A 2-year-old boy developed generalized edema 5 days after a bee sting. The laboratory investigations revealed nephrotic range proteinuria, hypoproteinemia, hypoalbuminemia and hyperlipidemia. The corticosteroid treatment induced prompt remission with resolution of edema and normalization of the laboratory findings. There was no relapse of the disease during the 13-year follow-up. Although spontaneous remission might occur, corticosteroid treatment induced prompt remission and shortened the hospital stay. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor in response to the article which examines the local and systemic reactions of bee stings on humans, published in the previous issue of the "Eye."