Ischemic Stroke Induced by Bee Sting in Agricultural Society – A Rare Complication of Bee Sting: A Case Report
Keywords:
Ischemic Stroke, Bee sting, rural areaAbstract
Abstract
Introduction:
Ischemic stroke is one of the highest causes of morbidity and mortality. One of the factors that triggers ischemic stroke which is quite rare is a bee sting. Pathomechanism of this condition remain unclear. This case report will describe a rare complication of bee sting and discuss it from a pathomechanism perspective.
Case Report:
A 40-year old woman came to the emergency room at Dr. Koesnadi Bondowoso with the main complaint of weakness in the right face. Referral patients from community health centers. The patient's complaint occurred 7,5 hours ago after being stung by a bee on the middle finger of his left hand. Physical examination showed facial angioedema, edema of digiti manus III sinsitra, and others normal. On neurological examination, it was found: Parasis Nervus XII and VII sinistra UMN type and hemiparasis sinistra. Laboratory examination showed increased neutrophils (90.4%) and eosinophilia (0.1%). A non-contrast CT scan examination showed a hypodense lesion in the right hemisphere. The patient was given antiplatelet, antihistamin, and neuroprotectan.
Discussion:
One of the rare complications of bee stings is ishemic stroke. This occurs due to the toxin from bee stings which contain vasoactive, pro-inflammatory agents, thrombogenic peptides, thromboxane A2, and leukotrienes which trigger platelet aggregation and vasoconstriction. This condition can trigger trombus formation and lead to ischemic stroke. Medical personnel, especially neurologists, must be aware of pathomechanism from the quite rare complications of ischemic stroke induced by bee stings, especially in rural areas
Keywords: Ischemic Stroke, Bee sting, rural area.
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References
Balagopal K, Muraleedharan A, Koshy AG, Jacob JP. Cerebral infarction following bee sting. Indian Journal of Medical Specialities. 2021; 12(2), 95-97
Bhaskar A, Singh G. Bee stings envenomation: a case report. International Journal of Research in Medical Sciences. 2022; 10(10), 2304–2306
Elavarasi, A., Haq, T. M., Thahira, T., Bineesh, C., & Kancharla, L. B. Acute Ischemic Stroke Due to Multiple Bee Stings_A Delayed Complication. Annals of Indian Academy of Neurology. 2020; 23(1), 135–136. https://doi.org/10.4103/aian.AIAN_118_19
Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, Abbasifard M, Abbasi-Kangevari M, Abd-Allah F, Abedi V, et al. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol. 2021;20:795–820. doi: 10.1016/S1474-4422(21)00252-0 Crossref.
Gupta, A. Acute fatal stroke associated with honeybee sting. Journal of Neurology & Neuromedicine. 2020; 5(1).
Gupta, P. N., Kumar, B. K., Velappan, P., & Sudheer, M. D. (2016). Possible complication of bee stings and a review of the cardiac effects of bee stings. BMJ case reports, 2016, bcr2015213974. https://doi.org/10.1136/bcr-2015-213974
Guzel M, Akar H, Erenler AK, Baydin A, Kayabas A. Acute ischemic stroke and severe multiorgan dysfunction due to multiple bee stings. Turk J Emerg Med 2016;16:126-8.
Ishitsuka, K., Kamouchi, M., Hata, J., Fukuda, K., Matsuo, R., Kuroda, J., Ago, T., Kuwashiro, T., Sugimori, H., Nakane, H., Kitazono, T., & FSR Investigators. High blood pressure after acute ischemic stroke is associated with poor clinical outcomes: Fukuoka Stroke Registry. Hypertension (Dallas, Tex. : 1979). 2014; 63(1), 54–60. https://doi.org/10.1161/HYPERTENSIONAHA.113.02189
Kabra, Ruchita & Andhale, Amol & Acharya, Sourya & Kumar, Sunil & Sawant, Rucha. Acute Ischemic Stroke Post Honeybee Sting: A Rare Case Report. Cureus. 2022; 14. 10.7759/cureus.31851.
Mahale, R., Mehta, A., Shankar, A. K., Buddaraju, K., John, A. A., Javali, M., & Srinivasa, R. (2016). Isolated posterior circulation stroke following honey-bee sting. Neurology India, 64 Suppl, S116–S118. https://doi.org/10.4103/0028-3886.178053
Mingomataj EC, Bakiri AH. 1 Episodic hemorrhage during honeybee venom anaphylaxis: potential mechanisms. Journal of Investigational Allergology and Clinical Immunology. 2012; 22(4), 237.
Pierik R, Algra A, van Dijk E, Erasmus ME, van Gelder IC, Koudstaal PJ, Luijckx GR, Nederkoorn PJ, van Oostenbrugge RJ, Ruigrok YM, Scheeren TWL, Uyttenboogaart M, Visser MC, Wermer MJH, van den Bergh WM., on behalf of the Parelsnoer Institute-Cerebrovascular Accident Study Group. Distribution of Cardioembolic Stroke: A Cohort Study. Cerebrovasc Dis. 2020;49(1):97-104.
Pu, L., Wang, L., Zhang, R., Zhao, T., Jiang, Y., & Han, L. Projected Global Trends in Ischemic Stroke Incidence, Deaths and Disability-Adjusted Life Years From 2020 to 2030. 2023. Stroke, 54(5), 1330–1339. https://doi.org/10.1161/STROKEAHA.122.040073
Thwe, E. E., Sudnik, P., Dobrovolschi, C., & Krishnamurthy, M. (2022). Kounis Syndrome: An Allergic Acute Coronary Syndrome Due to a Bee Sting. Cureus, 14(6), e26395. https://doi.org/10.7759/cureus.26395
Witharana, E. W., Wijesinghe, S. K., Pradeepa, K. S., Karunaratne, W. A., & Jayasinghe, S. (2015). Bee and wasp stings in Deniyaya; a series of 322 cases. The Ceylon medical journal, 60(1), 5–9. https://doi.org/10.4038/cmj.v60i1.7406
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