du Toit-Prinsloo Lorraine, Morris Neil Kennith, Meyer Pieter, Saayman Gert
Department of Forensic Medicine, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa.
Department of Immunology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa.
Forensic Sci Med Pathol. 2016 Mar;12(1):81-5. doi: 10.1007/s12024-015-9737-x. Epub 2016 Jan 12.
In South Africa bee stings are most commonly caused by either Apis mellifera capensis or A. mellifera scutellata, indigenous species which are notoriously aggressive when compared to European honey bees. According to Statistics South Africa, 109 deaths were documented for the period 2001-2011 as having been caused by hornets, wasps, and bees (ICD10-X26). This appears to be a small number but, as was reported in Australia, these statistics might be inaccurate due to either over- or underreporting of cases. We report 3 cases of fatalities due to bee stings, including one with postmortem features of diffuse intravascular coagulopathy. A brief overview of the venom of the honey bee, reactions following a bee sting and possible mechanisms of death are presented. Confirming the diagnosis in these cases may be very problematic for the forensic pathologist, as in many cases minimal history is available and both external and internal examination could fail to reveal any specific signs of bee sting or other obvious morphologic abnormalities. Thus, there is a need for reliable confirmatory or supportive diagnostic tests.
在南非，蜜蜂蜇伤最常见的原因是开普蜜蜂（Apis mellifera capensis）或盾形蜜蜂（A. mellifera scutellata），与欧洲蜜蜂相比，这两种本土蜜蜂具有极强的攻击性。据南非统计局统计，2001年至2011年期间，有记录显示109人死于黄蜂、胡蜂和蜜蜂蜇伤（国际疾病分类第十版，编码X26）。这一数字看似不多，但正如澳大利亚所报道的那样，由于病例报告可能存在过多或过少的情况，这些统计数据可能并不准确。我们报告了3例因蜜蜂蜇伤致死的病例，其中1例具有弥漫性血管内凝血的尸检特征。本文简要概述了蜜蜂毒液、蜜蜂蜇伤后的反应以及可能的死亡机制。对于法医病理学家来说，在这些病例中确诊可能非常困难，因为在许多情况下，可供参考的病史很少，而且尸体的外部和内部检查可能都无法发现任何蜜蜂蜇伤的特定迹象或其他明显的形态学异常。因此，需要可靠的确诊或辅助诊断测试。
