Alemán Navas Ramón Manuel, Martínez Mendoza María Guadalupe, Herrera Henry, Herrera Helen Piccolo de
Department of Oral and Maxillofacial Surgery, Zacamil's Nacional Hospital, Evangelic University of El Salvador, San Salvador, El Salvador.
Braz Dent J. 2009;20(3):249-53. doi: 10.1590/s0103-64402009000300014.
Hymenoptera order includes bees, which have a stinging apparatus at the tail capable of delivering venom to the affected tissues. Myocardial infarction, acute renal failure, Necrotizing fasciitis, fatal infection and hemifacial asymmetry, are some of the unusual reactions reported following hymenoptera stings. This paper reports a case of bee sting in the right floor of the nose that mimicked an odontogenic infection affecting the upper lip, canine space and nasal cavity such as in cases of infection secondary to pulpal or periodontal pathology of the anterior teeth. After a thorough clinical and radiographic examination, odontogenic infection was discarded and the diagnosis of floor of the nose mucosal lysis and lip abscess secondary to a bee sting was made. This case was successfully managed with adequate incision, drainage and antibiotics without any further complication. There are several reports of unusual reactions following hymenoptera stings. However, just a few of them referred to infections of local reactions and none of them related to the anatomic location affected in the patient of the present case. Early diagnosis and treatment prevented infection dissemination and the likelihood of tissue necrosis as in previously reported cases of Necrotizing fasciitis.
膜翅目昆虫包括蜜蜂,其尾部有一个能够将毒液输送到受影响组织的蜇刺器官。心肌梗死、急性肾衰竭、坏死性筋膜炎、致命感染和面部不对称,是膜翅目昆虫蜇伤后报道的一些异常反应。本文报告了一例右侧鼻底蜜蜂蜇伤病例,该病例类似牙源性感染,累及上唇、尖牙间隙和鼻腔,就像前牙牙髓或牙周病变继发感染的情况一样。经过全面的临床和影像学检查,排除了牙源性感染,并诊断为鼻底黏膜溶解和蜜蜂蜇伤继发唇部脓肿。该病例通过充分的切开、引流和抗生素治疗成功处理,未出现任何进一步的并发症。有几篇关于膜翅目昆虫蜇伤后异常反应的报道。然而,其中只有少数提到了局部反应感染,而且没有一篇与本病例患者受影响的解剖部位相关。早期诊断和治疗预防了感染扩散以及组织坏死的可能性,就像之前报道的坏死性筋膜炎病例一样。