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一例结膜蜂蜇伤病例并文献复习:眼部蜂蜇伤

A Case of Conjunctival Bee Sting Injury with Review of the Literature on Ocular Bee Stings.

作者信息

Semler-Collery Axelle, Hayek George, Ramadier Sophie, Perone Jean-Marc

机构信息

Department of Ophthalmology, Regional Hospital Center of Metz-Thionville, Mercy Hospital, Metz-Cedex, France.

Institut Paris Descartes, Sorbonne Paris Cité, University Imagine Institute, Paris, France.

出版信息

Am J Case Rep. 2019 Aug 31;20:1284-1289. doi: 10.12659/AJCR.917592.

Abstract

BACKGROUND Ocular bee stings have been rarely described in the literature, and their management is controversial. A case of conjunctival bee sting with retention of the stinger for 48 hours is presented with a review of the literature on the complications and management of ocular bee sting injury. CASE REPORT A 22-year-old beekeeper presented to the Emergency Department with mild symptoms from a conjunctival bee sting that he had received 48 hours previously. The stinger was removed in the Emergency Department, and topical antibiotic and anti-inflammatory treatment with corticosteroid were given. There were no complications in this case. However, review of the literature has shown that although the outcome from ocular bee stings can be mild, as in this case, ocular bee stings can result in severe visual symptoms that require amniotic membrane transplant (AMT). Management commonly includes removal of the stinger and both topical and systemic treatment with corticosteroids. The main complications include cataracts, inflammation of the anterior chamber, optic neuropathies, and changes in ocular pressure. CONCLUSIONS Ocular bee stings have been rarely described in the literature, and the management remains controversial. As this case has shown, removal of the stinger and the use of topical treatment with antibiotics and corticosteroids can prevent potentially serious complications that may affect vision. Early and regular follow-up with ocular imaging may be required when symptoms persist.

摘要

背景

眼部蜂蜇伤在文献中鲜有描述,其治疗方法存在争议。本文报告一例结膜蜂蜇伤且蜇刺残留48小时的病例,并回顾眼部蜂蜇伤损伤的并发症及治疗的相关文献。病例报告:一名22岁的养蜂人因48小时前结膜被蜂蜇伤后出现轻微症状就诊于急诊科。蜇刺在急诊科被取出,并给予局部抗生素及皮质类固醇抗炎治疗。该病例无并发症发生。然而,文献回顾显示,尽管眼部蜂蜇伤的结果可能像本病例一样轻微,但也可能导致需要羊膜移植(AMT)的严重视觉症状。治疗通常包括取出蜇刺以及局部和全身使用皮质类固醇。主要并发症包括白内障、前房炎症、视神经病变和眼压变化。结论:眼部蜂蜇伤在文献中鲜有描述,其治疗仍存在争议。如本病例所示,取出蜇刺并使用局部抗生素和皮质类固醇治疗可预防可能影响视力的潜在严重并发症。症状持续时可能需要早期定期进行眼部影像学检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66de/6735618/d97243bcf981/amjcaserep-20-1284-g001.jpg

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