Bee sting envenomation resulting in gross haematuria in an eight-year-old Nigerian male with sickle cell anaemia: A case report

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Date: January-February 2015
From: Nigerian Medical Journal(Vol. 56, Issue 1)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Clinical report
Length: 1,276 words
Lexile Measure: 1550L

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Byline: Kelechi. Odinaka, Kingsley. Achigbu, Ifeanyi. Ike, Francis. Iregbu

Gross haematuria is an unusual complication of Honey bee stings. Herein, we report a rare case of gross haematuria following multiple honeybees stings in an 8-year-old Nigerian child with sickle cell anaemia. The patient had evidence of massive intravascular haemolysis and was transfused with a unit of fresh whole blood. However, he died within 36 hours on admission despite medical intervention.

INTRODUCTION

Insects that sting to defend their colonies or subdue their prey belong to the order Hymenoptera, which includes bees, wasps, hornets, yellow jackets and fire ants. [sup][1] Honeybees are beneficial to man because they produce honey, which has nutritional and medicinal benefits. They are also important pollinators essential for the propagation of plants, including many agriculturally important crops. [sup][2] Despite these benefits, being stung by a bee is an unforgettable painful experience and can lead to untimely death. Bee stings occur as accidents or occupational exposure, especially in rural areas, within close proximity to forests, [sup][3] or in bee farms. The clinical manifestations of bee sting range from local or benign to systemic life threatening multisystem involvement, which result from allergic and/or anaphylactic to toxic reactions. Bee venom contains many toxic fractions, the most important being mellitin, which alters capillary permeability, causes local pain, haemolyses red cells and lowers blood pressure. [sup][4] The venom also contains antigenic components which are capable of invoking an allergic response in the form of hypersensitivity in a significant proportion of the population, if subjected to a subsequent challenge. Multiple stings, usually in excess of 100, may result in significant haemolysis with acute anaemia and subsequent renal failure. [sup][4] A bee dies after stinging her victim, leaving the barbed end of her stinger apparatus, or ovipositor, firmly embedded in the skin. [sup][5] There are a few reports on the uncommon reactions to bee sting which include acute renal failure and haematuria. [sup][3],[6] However,...

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Gale Document Number: GALE|A398486006