Ischemic Stroke After Bee Sting: A Case Report

Öz

Introduction The global impact of a bee sting extends beyond common perceptions, showing various indications that may range from local reactions to more severe complication. This report details a compelling case involving a 63-year-old male who developed neurological deficits merely six hours after a bee sting. Case Report A 63 -year-old male patient was brought to the emergency department because of widespread redness, pain and itching at the sting area after a bee sting while pruning roses in the garden. During the follow-up in the emergency room, the patient developed weakness in his right lower/upper extremities. However, the diffusion magnetic resonance imaging of the patient showed an infarction detected in the area adjacent to the left lateral ventricle (Figure1). Discussion Various clinical presentations after a bee sting have been described in the literature. Bee sting cases are generally associated with mild and transient local symptoms. Sometimes life-threatening allergic reactions may occur. Conclusion The scarcity of the reported after-sting strokes emphasizes the need for further exploration into this uncharted territory to better comprehend and manage these exceptional indications. This case is presented for its rarity, underscoring the imperative for increased attention and research on these complications. Keywords: Bee sting, ischemic, stroke. References 1. Clarck RF. Hymenoptera. In: Olson KR, editor. Poisoning and drug overdose. 4th ed. New York: LangeMedical. Books/McGrawHill; 2004. p. 225–6. 2. Dikici S, Aydin LY, Saritas A, Kudas O, Kandis H. An unusual presentation of bee sting: subarachnoid hemorrhagia. Am J Emerg Med 2012;30(8):1663.3. 3. Steen CJ, Janniger CK, Schutzer SE, Schwartz RA. Insect sting reactions to bees, wasp and ants. Int J Dermatol 2005; 44:91–4. 4. Kalyoncu AF, Demir AU, Ozcan U, Ozkuyumcu C, Sahin AA, Barış YI. Bee and wasp venom allergy in Turkey. Ann Allergy Asthma Immunol 1997; 78:408–12. 5. Falco OB, Plewing G, Wolff HH, Burgdorf WHC. Dermatology. 2nd ed. Berlin: Springer Verlag; 2000. p. 360–80 6. Golden DB, Tracy JM, Freeman TM, Hoffman DR, Insect Commitlee of the American Academy of Allergy. Asthma and immunology. Negative venom skin test result in patients with histories of systemic reaction to a sting. J Allergy Clin Immunol 2003; 112:495–8. 7. Rajendiran C, Puvanalingam A, Thangam D, Ragunanthanan S, Ramesh D, Venkatesan S, et al. Stroke after multiple bee sting. J Assoc Physicians India 2012; 60:122–4. 8. Ekmekyapar, T., Ekmekyapar, M., Gürbüz, Ş., & Oğuztürk, H. (2020). Unexpected acute aorta dissection with ischemic stroke. Journal of Emergency Medicine Case Reports, 11(2), 53-56. 9. Vidhate Mr, Sharma P, Verma R, Yaday R. Bilateral cavernous sinus syndrome and bilateral cerebral infacts: A rare combination after wasp sting. J Neuaol Sci. 2011; 15: 301(1-): 104–6. 10. Loh HH, Tan CH. Acute renal failure and posterior reversible encephalopathy syndrome following multiple wasp sting: a case report. Med J Malaysia 2012;67(1):133–5.

Anahtar Kelimeler

• bee sting
• ischemic
• stroke

Kaynakça

1. 1. Clarck RF. Hymenoptera. In: Olson KR, editor. Poisoning and drug overdose. 4th ed. New York: LangeMedical. Books/McGrawHill; 2004. p. 225–6.
2. 2. Dikici S, Aydin LY, Saritas A, Kudas O, Kandis H. An unusual presentation of bee sting: subarachnoid hemorrhagia. Am J Emerg Med 2012;30(8):1663.3,
3. 3. Steen CJ, Janniger CK, Schutzer SE, Schwartz RA. Insect sting reactions to bees, wasp and ants. Int J Dermatol 2005;44:91–4.
4. 4. Kalyoncu AF, Demir AU, Ozcan U, Ozkuyumcu C, Sahin AA, Barış YI. Bee and wasp venom allergy in Turkey. Ann Allergy Asthma Immunol 1997;78:408–12.
5. 5. Falco OB, Plewing G, Wolff HH, Burgdorf WHC. Dermatology. 2nd ed.. Berlin: Springer Verlag; 2000. p. 360–80
6. 6. Golden DB, Tracy JM, Freeman TM, Hoffman DR, Insect Commitlee of the American Academy of Allergy. Asthma and immunology. Negative venom skin test result in patients with histories of systemic reaction to a sting. J Allergy Clin Immunol 2003;112:495–8.
7. 7.Rajendiran C, Puvanalingam A, Thangam D, Ragunanthanan S, Ramesh D, Venkatesan S, et al. Stroke after multiple bee sting. J Assoc Physicians India 2012;60:122–4.
8. 8. Ekmekyapar T, Ekmekyapar M, Gürbüz Ş, Oğuztürk H. Unexpected acute aorta dissection with ischemic stroke. Journal of Emergency Medicine Case Reports.2020; 11(2): 53-56.

9. 9. VidhateMr, Sharma P, Verma R, Yaday R. Bilateral cavernous sinus syndrome and bilateral cerebral infacts: A rare combination after wasp sting. J Neuaol Sci. 2011; 15: 301(1-): 104–6.
10. 10. Loh HH, Tan CH. Acute renal failure and posterior reversible encephalopathy syndrome following multiple wasp sting: a case report. Med J Malaysia 2012;67(1):133–5.