Abstract
Arı sokmaları, tüm böcek sokmaları içerisinde en sık olanıdır. Nörolojik etkilenme nadirdir. Ancak ensefalit, akut dissemine ensefalomiyelit, polinöropati ve ekstrapiramidal tutulum ortaya çıkabilmektedir. 79 yaşında erkek hasta sol hemiparezi ve dizartri yakınması ile başvurdu. 1 gün önce 10 tane bal arısı tarafından sokulduğu öğrenildi. Sol kol ve bacakta 4/5 kas gücü, ataksik yürüme ve dizartri bulunmaktaydı. Difüzyon ağırlıklı manyetik rezonans görüntülemede sağ ponsta akut iskemi ile uyumlu lezyon belirlendi. Asetilsalisilik asit 300 mg/gün vemetformin 1000 mg/gün başlandı. Arı sokması sonrası salgılanan kimyasal moleküller ile tromboza eğilim artmaktadır. Bu nedenle iskemik inme riski olan hastalar yakın takip edilmelidir. Gerekirse hastalar bu moleküllerin inaktivasyonunu sağlayan ilaçlar ile tedavi edilmelidir. Ancak hipotansiyon ve vazokonstriksiyon oluşturabilen antialerjik ilaçlar başlanmamalıdır
Keywords
References
- Cardoso DC, Cristiano MP, Raymundo MS, Costa S, Zoc- che JJ. Epidemiology and injuries (1994-2005) resulting from poisonous animals in southern Santa Catarina State, Brazil. J Public Health 2007;15:467-72.
- Satya ASV, Gambhir IS, Suba Rao S, et al. A case of post beesting encephalitis. African J Neurological Sciences 2006;25:69-72.
- Bilo MB, Bonifazi F. The natural history and epidemiology of insect venom allergy: clinical implications. Clin Exp Al- lergy 2009;39:1467-76.
- Hiran S, Pande TK, Pani S, Gupta R, Vishwanathan KA. Rhabdomyolysis due to multiple honey bee stings. Postgrad Med J 1994;70:937.
- Truskinovsky AM, Dick JD, Hutchins GM. Fatal infection after a bee sting. Clin Infect Dis 2001;32:36-8.
- Fisher BA, Antonios TF. Atrial flutter following a wasp sting. J Postgrad Med 2003; 49:254-5.
- Agarwal V, DCruz S, Sachdev A, Singh R, Kapoor V. Quad- riparesis following wasp sting: an unusual reaction. Indian J Med Sci 2005;59:117-9.
- Golden DB, Valentine MD, Kagey-Sobotka A, Lichtenste- in LM. Regimens of hymenoptera venom immunotherapy. Ann Intern Med 1980;92:620-4.
- Reisman RE. Unusual reactions to insect stings. Curr Opin Allergy Clin Immunol 2005;5:355-8.
- Panagariya A, Sureka RK, Sharma B, Sardana V. Neurologi- cal complications following honey bee sting. J Assoc Physi- cians India 1998;46:984.
- Dikici S, Aydin LY, Saritas A, Kudas O, Kandis H. An unu- sual presentation of bee sting: subarachnoid hemorrhagia. Am J Emerg Med 2012;30:1663.
- Schiffman JS, Tang RA, Ulysses E, Dorotheo N, Singh SS, Bahrani HM. Bilateral ischaemic optic neuropat- hy and stroke after multiple bee stings. Br J Ophthalmol 2004;88:1596-8.
- Guzel M, Akar H, Erenler AK, Baydin A, Kayabas A. Acute ischemic stroke and severe multiorgan dysfunction due to multiple bee stings. Turkish journal of emergency medicine 2016;16:126-8.
- Law DA, Beto RJ, Dulaney J, Jain AC, Lobban JH, Schmidt SB. Atrial flutter and fibrillation following bee stings. Am J Cardiol 1997;80:1255.
- Tisdale JE, Patel RV, Webb CR, Borzak S, Zarowitz BJ. Pro- arrhythmic effects of intravenous vasopressors. Ann Phar- macother 1995;29:269-81.
Abstract
Bee stings are the most common of all insect all insect insert strings. Neurological involvement is rare. However, encephalitis, acute disseminated encephalomyelitis, polyneuropathy and extrapyramidal disease may ocur. A 79-year-old male patient presented with left hemiparesis and dysarthria. It was learned that he was stung by 10 honey bees 1 day ago. Left hemiparesis 4/5 , ataxic walking and dysarthria were deteced. A lesion like acute ischemia was revealedin the right pontine are awith diffusion-weighted magnetic resonance imaging. Acetylsalicylic acid 300 mg/day and metformin 1000 mg/day were started. Thrombosis predisposition increases with secreted chemical molecules after bee sting. There fore, patients with risk of ischemic stroke should be closely monitored. If necessary, patients should be treated with drugs that provide inactivation of these molecules. However, antiallergic drugs that can cause vasoconstriction and hypotension should not be started
Keywords
References
- Cardoso DC, Cristiano MP, Raymundo MS, Costa S, Zoc- che JJ. Epidemiology and injuries (1994-2005) resulting from poisonous animals in southern Santa Catarina State, Brazil. J Public Health 2007;15:467-72.
- Satya ASV, Gambhir IS, Suba Rao S, et al. A case of post beesting encephalitis. African J Neurological Sciences 2006;25:69-72.
- Bilo MB, Bonifazi F. The natural history and epidemiology of insect venom allergy: clinical implications. Clin Exp Al- lergy 2009;39:1467-76.
- Hiran S, Pande TK, Pani S, Gupta R, Vishwanathan KA. Rhabdomyolysis due to multiple honey bee stings. Postgrad Med J 1994;70:937.
- Truskinovsky AM, Dick JD, Hutchins GM. Fatal infection after a bee sting. Clin Infect Dis 2001;32:36-8.
- Fisher BA, Antonios TF. Atrial flutter following a wasp sting. J Postgrad Med 2003; 49:254-5.
- Agarwal V, DCruz S, Sachdev A, Singh R, Kapoor V. Quad- riparesis following wasp sting: an unusual reaction. Indian J Med Sci 2005;59:117-9.
- Golden DB, Valentine MD, Kagey-Sobotka A, Lichtenste- in LM. Regimens of hymenoptera venom immunotherapy. Ann Intern Med 1980;92:620-4.
- Reisman RE. Unusual reactions to insect stings. Curr Opin Allergy Clin Immunol 2005;5:355-8.
- Panagariya A, Sureka RK, Sharma B, Sardana V. Neurologi- cal complications following honey bee sting. J Assoc Physi- cians India 1998;46:984.
- Dikici S, Aydin LY, Saritas A, Kudas O, Kandis H. An unu- sual presentation of bee sting: subarachnoid hemorrhagia. Am J Emerg Med 2012;30:1663.
- Schiffman JS, Tang RA, Ulysses E, Dorotheo N, Singh SS, Bahrani HM. Bilateral ischaemic optic neuropat- hy and stroke after multiple bee stings. Br J Ophthalmol 2004;88:1596-8.
- Guzel M, Akar H, Erenler AK, Baydin A, Kayabas A. Acute ischemic stroke and severe multiorgan dysfunction due to multiple bee stings. Turkish journal of emergency medicine 2016;16:126-8.
- Law DA, Beto RJ, Dulaney J, Jain AC, Lobban JH, Schmidt SB. Atrial flutter and fibrillation following bee stings. Am J Cardiol 1997;80:1255.
- Tisdale JE, Patel RV, Webb CR, Borzak S, Zarowitz BJ. Pro- arrhythmic effects of intravenous vasopressors. Ann Phar- macother 1995;29:269-81.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 1, 2018 |
| Published in Issue | Year 2018 Volume: 28 Issue: 4 |
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