Citation

Pillur Tamilarasu K, Shankar T, Kabi A. BMJ Case Rep. 2021; 14(7): e242440.

Copyright

(Copyright © 2021, BMJ Publishing Group)

DOI

10.1136/bcr-2021-242440

PMID

unavailable

Abstract

A bee sting can result in allergic and toxin-mediated local manifestations like pain, swelling, redness and itching to serious systemic effects like acute kidney injury (AKI), pancreatitis, Kounis syndrome and stroke. Melittin and phospholipase A2, which make up 62% of honeybee venom, have vasoactive, haemolytic properties causing severe AKI. Its role in lowering blood glucose in diabetics is an interesting research topic. We report an elderly herdsman, a known diabetic on irregular oral hypoglycaemic drugs, who presented with altered mental status due to hypoglycaemia. On further prodding, a recent multiple bee sting attack 5 days ago was found which was followed by altered coloured urine for 2 days for which no medical attention was sought. Additional analyses revealed reticulocytosis, azotemia and high serum creatine phosphokinase. The patient was treated with dextrose infusion, antihistamines, fluids and haemodialysis. Renal failure resolved completely and the patient was discharged in a stable condition.

Language: en

Keywords

Aged; Humans; Animals; poisoning; *Bee Venoms; *Hypoglycemia/etiology; *Insect Bites and Stings/complications; Allergens; Bees; diabetes; Melitten