Unusual reactions to insect stings.
OBJECTIVE
A variety of unusual or unexpected reactions have occurred in a temporal relationship to insect stings. This review will summarize these case history reports in recent years. As these reactions are very infrequent, the review will also include prior reported unusual reactions attributed to insect stings.


RESULTS
Acute encephalopathy occurred 8 days after yellow jacket stings, without any other obvious cause. There have been prior reports of other neurological reactions, myasthenia gravis, peripheral neuritis and Guillain-Barré syndrome related to insect stings. Acute renal failure with tubular necrosis has occurred following massive numbers of stings from Africanized honeybees. Nephrotic syndrome has been reported in the past following single stings. Silent myocardial infarction has occurred, probably related to acute anaphylactic symptoms immediately following a sting. There are recent reports of other pathology, diffuse alveolar hemorrhage and rhabdomyolysis and prior reports of thrombocytopenic purpura and vasculitis. As the result of ocular stings, local reactions have occurred with corneal pathology leading to cataracts. Other prior reported reactions to ocular stings include conjunctivitis, corneal infiltration, lens subluxation, and optic neuropathy. There is scarce information regarding the pathogenesis of the majority of the unusual reactions and the subsequent allergic status or risk for sting anaphylaxis of people who have had these unusual reactions.


CONCLUSIONS
This review includes a variety of reactions, particularly involving neurological, renal and cardiovascular symptoms, related to insect stings. It is important that clinicians be aware of this relationship when assessing people with these reactions and address future prophylaxis.
School of Medicine, State University of New York at Buffalo, Buffalo, New York, USA. reisman@buffalomedicalgroup.com
Robert E
RE
Reisman
D058186:Acute Kidney Injury / Q000209:etiology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000818:Animals; D001514:Bee Venoms / Q000009:adverse effects; D004679:Encephalomyelitis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006927:Hymenoptera; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality; D007299:Insect Bites and Stings / Q000175:diagnosis* / Q000276:immunology* / Q000401:mortality; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D014862:Wasp Venoms / Q000009:adverse effects
D001514:Bee Venoms; D014862:Wasp Venoms