title: Bee swarmings in children.
abstract: Africanized honeybees (Apis mellifera scutellata) are now found in the southern and southwestern United States. Swarmings can result in hundreds to thousands of stings delivering a venom load capable of producing multisystem organ failure and death. The literature on mass envenomations is scarce, being limited to case reports and case series. There are no prospective studies on mass envenomations in children.
  
  
  METHODS
  All patients were admitted to our toxicology service, and all stingers were counted. Laboratory data and clinical assessments were obtained at baseline, 8, and 16 hours after presentation.
  
  
  RESULTS
  Nineteen patients with a median age of 3.6 years and a median of 2.64 stings per kilogram (range, 1-4.5) were enrolled. Fifteen children had vomiting. Only a mild increase in creatine kinase was seen. None developed coagulopathy or renal insufficiency.
  
  
  CONCLUSIONS
  Envenomations of up to 4.5 stings per kilogram resulted in only mild systemic illness. Vomiting does not portend involvement of other organ systems.
authors.affiliation: Department of Medical Toxicology and Banner Good Samaritan Regional Poison Center, Phoenix, AZ, USA. frank.lovecchio@bannerhealth.com
authors.forename: Frank
authors.initials: F
authors.lastname: Lovecchio
authors.forename: Robert D
authors.initials: RD
authors.lastname: Cannon
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Algier
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Ruha
authors.forename: Steven C
authors.initials: SC
authors.lastname: Curry
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Wallace
authors.forename: Kimberley A
authors.initials: KA
authors.lastname: Graeme
mesh_terms: D000818:Animals; D001516:Bees; D001522:Behavior, Animal; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications*