Alterações oculares decorrentes de picada de abelha na córnea / Ocular changes due to corneal bee sting

RESUMO O propósito deste estudo foi reportar as alterações oculares observadas após picada de abelha com ferrão retido na córnea. Destacamos o tratamento e o desfecho de uma lesão de córnea incomum e sua patogênese. Trata-se de relato de caso e revisão da literatura de lesões oculares por picada de abelha. Paciente do sexo feminino, 63 anos, procurou atendimento oftalmológico de urgência devido à picada de abelha na córnea do olho direito há 6 dias. Queixava-se de embaçamento visual, dor e hiperemia ocular. Apresentou acuidade visual de vultos no olho afetado. Ao exame, notaram-se hiperemia moderada de conjuntiva bulbar, edema corneano com dobras de Descemet e presença do ferrão alojado na região temporal, no estroma profundo da córnea. A paciente foi internada para ser abordada no centro cirúrgico sob anestesia geral. Durante a cirurgia, o ferrão teve que ser retirado via câmara anterior, mediante a realização de uma paracentese e uma lavagem da câmara anterior, com dupla via e solução salina balanceada. Ainda não existe na literatura um tratamento padrão na abordagem de pacientes com lesões oculares por picada de abelha, sendo importantes a identificação e o reconhecimento precoce de possíveis complicações que ameacem a visão.

ABSTRACT The purpose of this study was to report the ocular changes observed after a bee sting with a stinger retained in the cornea. We show the treatment and outcome of an unusual corneal injury and its pathogenesis. This is a case report and literature review of ocular injuries caused by bee stings. A 63-year-old female patient sought emergency ophthalmic care because of a bee sting on the cornea of her right eye six days before. She complained of blurred vision, pain, and ocular hyperemia. She had glare sensitivity on visual acuity in the affected eye. Examination revealed moderate hyperemia of the bulbar conjunctiva, corneal edema with Descemet's folds and a stinger lodged in the temporal region, in the deep stroma of the cornea. The patient was admitted to the operating room under general anesthesia. During surgery, the stinger had to be removed via the anterior chamber, by performing a paracentesis and washing the anterior chamber with a double flushing and balanced saline solution. There is still no standard treatment in the literature for patients with eye injuries caused by bee stings, and early identification and recognition of possible sight-threatening complications is important.

Acute bullous hemorrhagic prurigo: a diagnostic challenge

Abstract Insect bites and bite wounds are quite common and most often have mild repercussions in humans. Statistics on the incidence of accidents caused by insects are not available, and the skin reactions after the bites are not always known. The authors present two cases of patients with hemorrhagic blisters on their hands after tabanidae bites and discuss the factors that cause the problem and the importance of the differential diagnosis of blisters with hemorrhagic content on human skin.

Breakfast, lunch, and dinner sign: a hallmark of flea and bedbug bites

Abstract: Human, dog, and cat fleas, as well as bedbugs, feed by biting their victims, causing acute prurigo, which is aggravated in sensitized victims (papular urticaria). The lesions appear in the classic "breakfast, lunch, and dinner" pattern. There are two main explanations: the parasites "map" the skin area in search of the best places to bite, and their removal when victim scratches, and then reattach to the skin. Treatments aim to control pruritus, as well as hypersensitivity reactions when necessary. Prevention is based on environmental control measures. The "breakfast, lunch, and dinner" sign is a definitive marker for diagnosis and the parasite´s identification and control.

Generalized papular-purpuric eruption due to Solenopsis fugax bites

Abstract: A 59-year-old atopic man referred to for the onset of a diffused itching papular-purpuric eruption involving his trunk and legs but without systemic symptoms. History revealed that he started feeling itching after spending few hours in his basement. Direct examination of the environmental dust (www.edpa.it) showed high level of infestation of Solenopsis fugax, a small Myrmicinae ant. The skin eruption completely healed without scarring in 2 weeks. Specific disinfestation measures were performed and the patient did not comply of any recurrence during a 6-months follow-up.

Sympathetic Ophthalmia after Ocular Wasp Sting

No abstract available.

Dermoscopy as an auxiliary method in the diagnosis of social wasp (Hymenoptera, Vespidae) stings

We describe the case of a 32-year-old male patient that sought medical treatment complaining of severe pain in his second and third right-hand fingers. The symptoms had started two hours before. The hypotheses of spider bite, scorpion or insect sting and injury caused by a foreign body were considered in the differential diagnoses. On dermoscopy, two foreign bodies were identified on his skin. After extraction, we concluded that they were wasp stingers.

Human Sting of Cephalonomia gallicola (Hymenoptera: Bethylidae) in Korea

Hymenoptera stings can cause serious injury to humans. We report the clinical findings of 6 cases of Hymenoptera stings. All patients developed painful erythematous papules at the sting sites and had a past history of parasitoid wasp sting. This is the first clinical report of the parasitoid wasp, Cephalonomia gallicola, causing human stings in Korea.

Insect bite reactions.

Insects are a class of living creatures within the arthropods. Insect bite reactions are commonly seen in clinical practice. The present review touches upon the medically important insects and their places in the classification, the sparse literature on the epidemiology of insect bites in India, and different variables influencing the susceptibility of an individual to insect bites. Clinical features of mosquito bites, hypersensitivity to mosquito bites Epstein-Barr virus NK (HMB-EBV-NK) disease, eruptive pseudoangiomatosis, Skeeter syndrome, papular pruritic eruption of HIV/AIDS, and clinical features produced by bed bugs, Mexican chicken bugs, assassin bugs, kissing bugs, fleas, black flies, Blandford flies, louse flies, tsetse flies, midges, and thrips are discussed. Brief account is presented of the immunogenic components of mosquito and bed bug saliva. Papular urticaria is discussed including its epidemiology, the 5 stages of skin reaction, the SCRATCH principle as an aid in diagnosis, and the recent evidence supporting participation of types I, III, and IV hypersensitivity reactions in its causation is summarized. Recent developments in the treatment of pediculosis capitis including spinosad 0.9% suspension, benzyl alcohol 5% lotion, dimethicone 4% lotion, isopropyl myristate 50% rinse, and other suffocants are discussed within the context of evidence derived from randomized controlled trials and key findings of a recent systematic review. We also touch upon a non-chemical treatment of head lice and the ineffectiveness of egg-loosening products. Knockdown resistance (kdr) as the genetic mechanism making the lice nerves insensitive to permethrin is discussed along with the surprising contrary clinical evidence from Europe about efficacy of permethrin in children with head lice carrying kdr-like gene. The review also presents a brief account of insects as vectors of diseases and ends with discussion of prevention of insect bites and some serious adverse effects of mosquito coil smoke.

A Case of Hypersensitivity to Mosquito Bites without Peripheral Natural Killer Cell Lymphocytosis in a 6-Year-Old Korean Boy

Hypersensitivity to mosquito bites (HMB) is a rare disease characterized by intense skin reactions such as bulla and necrotic ulcerations at bite sites, accompanied by general symptoms such as high-grade fever and malaise occurred after mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer (NK) cell leukemia/lymphoma. We describe here a Korean child who presented with 3-yr history of HMB without natural killer cell lymphocytosis. He has been ill for 6 yr with HMB. Close observation and examination for the development of lymphoproliferative status or hematologic malignant disorders is needed.

Nasopharyngeal bleeding due to leech bites in a 9-month-old infant.

Leeches are annelids, comprising the subclass Hirudinea. There are freshwater, terrestrial and marine leeches. Haemophagic leeches attach to their hosts and remain there until they become filled up with blood and then they fall off to digest. Leech bites can manifest various symptoms, which lead to anemia. Here is reported, a case of leech bites in a 9-month-old infant, with a long history of hematemesis, melena, epistaxis and anemia which demanded repeated transfusions. So, leech bites may be a differential diagnosis of anemia particularly in the endemic rural areas where villagers use non boiled water.

Loxoscelismo: presentación de un caso cutáneo-visceral con resolución favorable / Loxoscelism: report of a viscerocutaneous case with favorable resolution

El loxoscelismo es una patología producida por picadura de arañas del género Loxosceles que en nuestro país está representado principalmente por L. laeta. Se caracteriza por necrosis cutánea y, en un bajo porcentaje, se acompaña de manifestaciones sistémicas que pueden conducir a la muerte. El objetivo de esta presentación es dar a conocer el caso clínico de un paciente de 6 años que desarrolló loxoscelismo cutáneo-visceral con buena evolución.

Acidente humano por lepidópteros / Human accident with lepidopterans

Relata-se, neste trabalho, o caso de um homem de 33 anos que se acidentou por contato da pele do antebraço direito com uma lagarta da família Megalopygidae, espécie Podalia sp. O diagnóstico foi realizado por meio de anamnese, manifestações clínicas e identificação da lagarta. O paciente apresentou dor intensa no local, que persistiu com prurido do quarto ao sétimo dia após o contato. A dor, na palpação, persistiu até o vigésimo quarto dia, acompanhada de hiperemia no antebraço e na região peitoral, seguida de dermatite intensa, interpretadas como relacionadas aos efeitos tóxicos do veneno.

Envenenamiento por picaduras de abeja / Poisoning by bee sting

Dentro de las patologías humanas producidas por animales con la capacidad de inocular veneno, las picaduras de abeja producen el mayor número de accidentes por animales en muchos países, superando a menudo en mortalidad a los producidos por serpientes, escorpiones y arañas. El cuadro clínico por la picadura de estos himenópteros puede consistir en fenómenos alérgicos o en cuadros de envenenamiento. Estos últimos se producen por el ataque de enjambres constituyendo un hecho grave que puede comprometer la vida. En el sujeto envenenado pueden observarse hemólisis, rabdomiólisis e insuficiencia renal, que junto a otras alteraciones sistémicas pueden conducir a la muerte. El conocimiento de los acontecimientos fisiopatológicos que se producen ante los ataques masivos de abejas es de suma importancia para el personal de salud dado que hasta la fecha no existen antivenenos que hayan demostrado tener eficacia clínica comprobada. En esta revisión se consideran los aspectos biológicos de las abejas y de la composición de su veneno relacionado con la ocurrencia y severidad de los accidentes, así como datos epidemiológicos de utilidad para enfrentarse a este tipo de cuadro.

Among the human pathologies produced by venomous animals, bee stings constitute the largest number of accidents in several countries, exceeding the mortality rate caused by other venomous animals such as snakes, spiders or scorpions. The clinical picture after the bee sting may include anaphylaxis or poisoning. The latter is produced by massive attacks and is a serious problem that may put the patient's life at risk. People that are poisoned display hemolysis, rhabdomiolysis and acute renal failure that together with other systemic failures can bring about death. The knowledge of the physiopathological mechanisms involved in the massive attack of bees is crucial for health care professionals as to date we do not ha ve antivenoms with proven clinical efficacy. In this review we include the bee's biological aspects, venom composition and its relation with the occurrence and severity of accidents as well as epidemiological data that can be useful for this type of accidents.

Enfermedades cutáneas producidas por algunos artrópodos en Chile / Cutaneous diseases caused by some arthropods in Chile

Existen muchos artrópodos que afectan al hombre y a animales. Algunos artrópodos sólo producen manifestaciones cutáneas o sistémicas, otros son vectores de diversas enfermedades. Las picaduras y mordeduras de artrópodos son un motivo de consulta muy frecuente en la práctica dermatológica diaria, la mayoría de diagnóstico y tratamiento fácil, sin complicaciones. A veces, sin embargo, las manifestaciones puden ser tan greves que producen la muerte. En ocaciones, por ejemplo, en pacientes que han viajado al extranjero, el diagnóstico de las lesiones puede ser difícil, y es necesario profundizar en los diagnósticos diferenciales. En este artículo revisamos las patologías cutáneas más frecuentes producidas por distintos artrópodos de las clases Insecta y Aracnida, tales como abejas, pulgas, moscas, chinches, vinchucas, arañas y escorpiones. Se describen con detalle las distintas manifestaciones cutáneas y sistémicas y se entregan algunos elementos teóricos en el tratamiento de éstas