Anaphylaxis usually develop immediately after wasp sting, but may develop even after few days later. Neurological complications after stings are uncommon, although several cases have been reported involving central and/or peripheral nervous system. Although wasp sting-induced encephalitis has been rarely reported, all reported cases showed mental change and severe neurological deterioration. Herein, we report an atypical case who showed biphasic anaphylaxis and delayed-onset cerebellar ataxia following a wasp sting, characterized by mild cerebellar ataxia and excellent response to corticosteroids.
Adrenal Cortex Hormones ; Anaphylaxis ; Bites and Stings ; Cerebellar Ataxia ; Encephalitis ; Peripheral Nervous System ; Wasps

PURPOSE: In the present study, the prognosis of ocular injury caused by a wasp sting was evaluated in two cases: Case 1 was treated by anterior chamber irrigation and Case 2 was simultaneously treated by anterior chamber irrigation and vitrectomy. CASE SUMMARY: Both patients had unilateral damage and complained of severe eye pain and blurred vision. Severe corneal edema, conjunctival injection, marked anterior chamber inflammatory reaction and the wasp sting through the cornea at the anterior chamber were observed in both cases. In Case 1, anterior chamber irrigation was performed, however, corneal edema was not recovered. Six months after the wasp sting, phthisis was observed. In Case 2, anterior chamber irrigation and vitrectomy were simultaneously performed, corneal edema decreased and epithelial healing occurred. Four months after the wasp sting, the eyeball was stable, but there was no wave on the electroretinogram. CONCLUSIONS: Unlike the ocular damage resulting from a bee sting, the ocular damage from a wasp sting causes severe toxic reactions and results in poor prognosis. Aggressive treatment including vitrectomy is necessary shortly after wasp sting injury to save both the vision and eyeball.
Anterior Chamber ; Bees ; Bites and Stings* ; Cornea ; Corneal Edema ; Eye Pain ; Humans ; Prognosis* ; Uveitis ; Vitrectomy ; Wasps*

No abstract available.
Animals ; Anti-Bacterial Agents ; Antihypertensive Agents ; Corneal Edema/diagnosis/etiology/therapy ; Corneal Injuries/diagnosis/*etiology/therapy ; Corneal Ulcer/diagnosis/etiology/therapy ; Drug Combinations ; Eye Enucleation ; Eye Pain/etiology ; Glaucoma/diagnosis/etiology/therapy ; Glucocorticoids ; Humans ; Insect Bites and Stings/diagnosis/*etiology/therapy ; Intraocular Pressure ; Male ; Middle Aged ; Mydriatics ; Ophthalmia, Sympathetic/diagnosis/*etiology/therapy ; Visual Acuity ; *Wasps

Kounis syndrome is the concurrence of acute coronary syndromes with conditions associated with mast cell activation following an allergic insult. We report a 56-year-old man who experienced a ST-segment elevation myocardial infarction after wasp stings. The patient presented without signs of anaphylaxis or shock. Coronary angiography showed an everolimus-eluting stent thrombosis (ST) of the left anterior descending artery occluding the vessel completely which was deployed for stable angina 3 years ago. The patient had been compliant with anti-platelet therapy, and no relevant cardiovascular events occurred until the day of admission. We interpreted our patient's condition as a manifestation of Kounis syndrome. To our knowledge, this is the first case of Kounis syndrome showing very late ST in a second-generation drug-eluting stent caused by wasp stings.
Acute Coronary Syndrome ; Angina, Stable ; Bites and Stings ; Coronary Angiography ; Drug-Eluting Stents ; Humans ; Hypersensitivity ; Mast Cells ; Middle Aged ; Myocardial Infarction ; Sirolimus ; Stents ; Thrombosis ; Wasps ; Everolimus

Aged ; Anaphylaxis ; etiology ; Animals ; Female ; Humans ; Insect Bites and Stings ; complications ; Myocardial Infarction ; etiology ; Wasps

PURPOSE: Although patient history is vital for the diagnosis of hymenoptera venom allergy, specific IgE detection is also important to identify the culprit insect and monitor the effect of immunotherapy. We evaluated the diagnostic value of serum-specific IgE detection of hymenoptera venom component allergens and documented changes in allergen-specific IgE after immunotherapy. METHODS: Fifty-six hymenoptera venom allergy patients receiving venom immunotherapy were recruited from Ajou University Hospital, Korea. The clinical manifestations of the patients were noted, and serum-specific IgE detection was performed, using conventional venom extracts as well as component allergens. Data were analyzed retrospectively. RESULTS: A total of 35 (62.5%) patients were male, and 33 (73.3%) patients were atopic. The mean patient age was 44.9+/-13.8 years. Localized reactions occurred in 23.2% of patients, and systemic reactions occurred in 76.8%. The most common clinical manifestations included skin involvement, such as urticaria and angioedema, and respiratory involvement. Yellow jackets were the most frequent culprit insect, followed by yellow hornets, white-faced hornets, honeybees, and paper wasps, as determined at the time of diagnosis. Double sensitization to both Apidae and Vespidae species was detected in 70.9% of patients. The positive predictive values (PPV) of rVes v 5-specific and rPol d 5-specific IgE detection were 85.7% and 87.5%, respectively, which correlated well with conventional venom extract-specific IgE detection (r=0.762 and r=0.757, respectively). In contrast, the PPV of rApi m 1-specific IgE detection at the time of diagnosis was 34.8%. Three years of venom immunotherapy resulted in decreased venom-specific IgE, particularly IgE specific for Vespidae venom components. CONCLUSIONS: Stings by yellow jackets and male sex may be risk factors for hymenoptera venom allergy in Korea. Vespidae component-specific IgE, but not Apidae component-specific IgE, had diagnostic and monitoring value in hymenoptera venom allergy comparable to that of conventional hymenoptera venom extract-specific IgE.
Allergens ; Angioedema ; Bees ; Bites and Stings ; Humans ; Hymenoptera ; Hypersensitivity ; Immunoglobulin E ; Immunotherapy ; Insects ; Korea ; Male ; Organothiophosphorus Compounds ; Risk Factors ; Skin ; Urticaria ; Venoms ; Wasps

We reported a case of multiple organ dysfunction syndrome (MODS) following about 300 wasp stings. The diagnosis was based on autopsy findings of acute pulmonary edema, acute kidney injury, hepatic and cardiac dysfunction, and cerebral edema. MODS is a life-threatening complication, and should be considered a possibility after multiple wasp stings. Our autopsy helped to establish the cause of unexpected death due to wasp stings and to elucidate a possible mechanism of MODS.
Adult ; Animals ; Fatal Outcome ; Female ; Humans ; Insect Bites and Stings ; complications ; Multiple Organ Failure ; etiology ; Wasps

BACKGROUND: Patients may receive negative results from a specific IgE (sIgE) test such as the ImmunoCAP (CAP) despite a documented history of systemic reaction to a Hymenoptera sting. Thus, further testing may be required using another serological method or venom skin prick tests to confirm allergy diagnosis and correct species. OBJECTIVE: To evaluate the sensitivity and the specificity of CAP and IMMULITE 3gAllergy (IMMULITE) for detecting sIgE to Paper wasp (WA) and Yellow Jacket (YJ) venoms using patient clinical history as the comparator. METHODS: Sera from 70 participants with a history of systemic reactions (SR) to WA and/or YJ stings were tested using CAP and IMMULITE. Fifty participants from this group had negative results on CAP. To assess specificity, sera from 71 participants who had never experienced either a WA or YJ sting were tested using CAP and IMMULITE. Fifty participants from this group tested positive using CAP. RESULTS: In participants with a history of systemic reaction to a Hymenoptera sting, yet who tested negative for WA and/or YJ sIgE according to CAP, the positivity rate according to IMMULITE was 20-42% using 0.10 IUA/mL as the limit of detection (LoD), per the manufacturer's specification. When the LoD for CAP (0.35 IUA/mL) was applied to the IMMULITE results, positivity according to IMMULITE was 14-26%. Overall, sensitivity, specificity, and agreement with SR were greater for IMMULITE than for CAP. For YJ: sensitivity (IMMULITE:CAP), 42.8%:28.5%; specificity, 53.5%:39.4%; agreement, 48.2%:34%. For WA, sensitivity (IMMULITE:CAP), 58.6%:28.5%; specificity, 49.3%:47.8%; agreement, 43.9%:38.3%. CONCLUSION: The IMMULITE performed well for detecting sIgE to Hymenoptera venom
Bites and Stings ; Diagnosis ; Humans ; Hymenoptera ; Hypersensitivity ; Immunoglobulin E ; Limit of Detection ; Methods ; Sensitivity and Specificity ; Skin ; Venoms ; Wasps

OBJECTIVETo examine the protective effects of wasp (Vespa magnifica) honeycomb extract (WCE) against gastric lesions in rats induced by 60% acidified ethanol, and evaluate its capacity to suppress oxidative stress in the gastric tissue.

METHODSWistar rats were subjected to intragastric administration of 60% acidified ethanol to induce gastric lesions following an 8-day oral pretreatment with WCE at 0, 25, 100 and 150 mg/kg or with saline. The levels of 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging, myeloperoxidase (MPO) activity and total antioxidant capacity in the gastric tissues were determined.

RESULTSOral administration of 25, 100 and 150 mg/kg WCE prior to 60% acidified ethanol administration significantly inhibited the formation of gastric lesions (with a reduction by 44.2%-87.1%), decreased the mucosal MPO activity (by 16.4%-56.6%) and increased the total antioxidant capacity of the gastric tissue (by 0.5, 1.47 and 1.83 folds, respectively) in a dose-dependent manner. At a high concentration (above 1 mg/ml), WCE also exhibited a stronger DPPH radical scavenging activity than butylated hydroxytoluene (BHT).

CONCLUSIONThe ethanol extract of wasp honeycombs can suppress the formation of acidified ethanol-induced gastric lesions by reducing free radical oxidation and neutrophils infiltration in the gastric tissue in rats.

Animals ; Antioxidants ; pharmacology ; therapeutic use ; Ethanol ; adverse effects ; Female ; Honey ; Male ; Materia Medica ; pharmacology ; therapeutic use ; Neutrophil Infiltration ; drug effects ; Oxidative Stress ; drug effects ; Peroxidase ; metabolism ; Rats ; Rats, Wistar ; Stomach Ulcer ; chemically induced ; prevention & control ; Wasps ; chemistry

Bee venom acupuncture have been associated with wide variety of reactions from mild local reaction to fatal systemic reaction. Vascular complications of bee and wasp stings are rare. A 71-year-old man developed pontine and thalamic infarction after honey bee venom acupuncture. Dysarthria and left hemiparesis were noted 3 days later. The brain MRI showed cerebral infarcts in the left pons and thalamus. The presumed mechanisms include vasoconstriction and platelet aggregation secondary to an injection of distinct allergens contained in bee venom acupuncture.
Acupuncture ; Aged ; Allergens ; Bee Venoms ; Bees ; Bites and Stings ; Brain ; Cerebral Infarction ; Dysarthria ; Honey ; Humans ; Infarction ; Paresis ; Platelet Aggregation ; Pons ; Thalamus ; Vasoconstriction ; Venoms ; Wasps