Odynophagia following retained bee stinger

Viswanathan S (1), Viswanathan S (2), Iqbal N (2), Shanmugam V (2), Srinath G (3)

(1) Department of Oral Pathology, Indira Gandhi Institute of Dental Sciences, Mahatma Gandhi Medical College and Research Institute Complex, Pilaiyarkuppam, Pondicherry, India; (2) Department of Internal Medicine, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry, India; (3) Department of Otorhinolaryngology, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry, India.

Abstract: Nearly half of Hymenoptera stings affect the head and neck region of victims, but reports on oropharyngeal bee stings are very few. We describe the case of a patient with odynophagia and suffocation in mass envenomation. He had a retained bee stinger whose removal was delayed for more than 24 hours following the sting, due to persisting angioedema. Odynophagia receded after removal of the stinger and treatment with paracetamol, steroids and metronidazole. The patient also developed rhabdomyolysis, renal failure and hepatitis that were treated with conservative therapy. Oropharyngeal stings can simulate symptoms of persisting angioedema in victims of mass envenomation.

Key words: intraoral bee sting, massive bee sting, oropharyngeal Hymenoptera stings, soft palate.

COPYRIGHT

© CEVAP 2012

SUBMISSION STATUS

Received: December 16, 2011.

Accepted: February 6, 2012.

Abstract published online: March 6, 2012.

Full paper published online: May 31, 2012.

CONFLICTS OF INTEREST

The authors declare no conflicts of interest.

ETHICS COMMITTEE APPROVAL

The present study was approved by the Department of Internal Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India. In addition, the patient signed an informed consent form.

CORRESPONDENCE TO

Stalin Viswanathan, Department of Internal Medicine, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry, 605014, South India. Phone: +91 0413 3051111. Email: stalinviswanathan@ymail.com.