Acute renal failure after massive honeybee stings

Two clinical cases of patients who survived after numerous attacks of Africanized bees (600 and 1500 bee stings, respectively) are reported. Clinical manifestation was characterized by diffuse and widespread edema, a burning sensation in the skin, headache, weakness, dizziness, generalized paresthes...

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Bibliographic Details
Main Authors: Elizabeth De Francesco Daher, Geraldo Bezerra da Silva Junior, Glaydcianne Pinheiro Bezerra, Lícia Borges Pontes, Alice Maria Costa Martins, José Ambrósio Guimarães
Format: Article in Journal/Newspaper
Language:English
Published: Universidade de São Paulo (USP) 2003
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Online Access:https://doaj.org/article/434377d807cc4085936812b436f8350b
Description
Summary:Two clinical cases of patients who survived after numerous attacks of Africanized bees (600 and 1500 bee stings, respectively) are reported. Clinical manifestation was characterized by diffuse and widespread edema, a burning sensation in the skin, headache, weakness, dizziness, generalized paresthesia, somnolence and hypotension. Acute renal failure developed and was attributed to hypotension, intravascular hemolysis, myoglobinuria due to rhabdomyolysis and probably to direct toxic effect of the massive quantity of injected venom. They were treated with antihistaminic, corticosteroids and fluid infusion. One of them had severe acute renal failure and dialysis was required. No clinical complication was observed during hospital stay and complete renal function recovery was observed in both patients. In conclusion, acute renal failure after bee stings is probably due to pigment nephropathy associated with hypovolemia. Early recognition of this syndrome is crucial to the successful management of these patients.