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 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.
Hospital Universitário Walter Cantídio, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal do Ceará, Hospital Geral de Fortaleza, Serviço de Nefrologia, Secretaria de Saúde do Estado do Ceará, Brasil. efdaher@for.terra.com.br
Elizabeth De Francesco
Ede F
Daher
Geraldo Bezerra
GB
da Silva Júnior
Glaydcianne Pinheiro
GP
Bezerra
Lícia Borges
LB
Pontes
Alice Maria Costa
AM
Martins
José Ambrósio
JA
Guimarães
D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000293:Adolescent; D000818:Animals; D001516:Bees; D002675:Child, Preschool; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications* / Q000188:drug therapy; D008297:Male; D006435:Renal Dialysis; D012206:Rhabdomyolysis / Q000209:etiology