Lam S M
Department of Internal Medicine, Chi-Mei Foundation Hospital, Yung Kang City, Tainan, Taiwan, ROC.
J Microbiol Immunol Infect. 1998 Jun;31(2):133-6.
A generalized allergic reaction to or anaphylaxis from honeybee sting may involve the skin with erythema, puritus, urticaria, or angioedema; the respiratory tract with laryngeal edema, and brochospasm; the cardiovascular system with myocardial depression, hypotension, and shock; and the gastrointestinal system with nausea, vomiting, and incontinence. Acute pulmonary hemorrhage following a honeybee sting has never been reported. We describe a previously healthy 14-year-old girl who developed acute pulmonary hemorrhage, hypotension, and generalized skin rash after a single honeybee sting on her right fourth finger. Her serum immunoglobulin E (IgE) was high (360 IU/mL). Chest X-ray revealed perihilar alveolar infiltrative lesions. Metabolic acidosis and hypoxemia were also found. After treatment with antihistamines, dopamine, corticosteroids, bronchodilaters, fluid replacement, and mechanical ventilation, her condition improved dramatically. A hypersensitivity reaction to honeybee venom is the most likely explanation for this unusual case of acute pulmonary hemorrhage.
对蜜蜂蜇伤的全身性过敏反应或过敏症可能累及皮肤，出现红斑、瘙痒、荨麻疹或血管性水肿；累及呼吸道，出现喉水肿和支气管痉挛；累及心血管系统，出现心肌抑制、低血压和休克；累及胃肠道系统，出现恶心、呕吐和大小便失禁。蜜蜂蜇伤后急性肺出血此前未见报道。我们描述了一名既往健康的14岁女孩，她右手无名指被蜜蜂蜇了一下后出现急性肺出血、低血压和全身性皮疹。她的血清免疫球蛋白E（IgE）水平很高（360 IU/mL）。胸部X线显示肺门周围肺泡浸润性病变。还发现了代谢性酸中毒和低氧血症。经过使用抗组胺药、多巴胺、皮质类固醇、支气管扩张剂、补液和机械通气治疗后，她的病情显著改善。对蜂毒的超敏反应最有可能解释这例罕见的急性肺出血病例。
