Pivoto João Guilherme Augusto, Bonates Paula, de Araújo Thelma Silva, Alencar Aline, da Silva Carvalho Érica, Baia-da-Silva Djane Clarys, de Almeida Gonçalves Sachett Jacqueline, Monteiro Wuelton Marcelo
Fundação de Medicina Tropical Dr. Heitor Vieira, Departamento de Ensino e Pesquisa, Manaus, Brazil.
Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, Brazil.
Am J Trop Med Hyg. 2022 Aug 8;107(3):701-4. doi: 10.4269/ajtmh.22-0218.
Hymenopteran venoms, inoculated during stings by ants, bees, and wasps, are the most frequent cause of an IgE-mediated systemic hypersensitivity reaction in adults, which is a key process in drastic manifestations of anaphylaxis. Respiratory involvement is usually caused by pulmonary edema but is rarely described as including interstitial pneumonitis or acute respiratory distress syndrome. Here, we describe a case of severe allergic reaction after a sting by Apoica pallens with late-onset pulmonary involvement, including signs of vasoplegia (pleural effusion) and interstitial pneumonitis with mild rhabdomyolysis. The presence of late onset of pulmonary involvement after a severe allergic reaction after a sting by A. pallens shows the importance of keeping a patient with severe reactions under medical care for a minimum of 5 days to avoid serious late complications outside the hospital environment.
蚂蚁、蜜蜂和黄蜂蜇刺时注入的膜翅目毒液，是成人IgE介导的全身性超敏反应最常见的原因，而这是过敏反应严重表现的关键过程。呼吸系统受累通常由肺水肿引起，但很少被描述为包括间质性肺炎或急性呼吸窘迫综合征。在此，我们描述了一例被淡足侧异腹胡蜂蜇伤后发生严重过敏反应并伴有迟发性肺部受累的病例，包括血管麻痹（胸腔积液）迹象和伴有轻度横纹肌溶解的间质性肺炎。淡足侧异腹胡蜂蜇伤后严重过敏反应出现迟发性肺部受累，这表明对于严重过敏反应患者，应至少留院观察5天，以避免在院外环境出现严重的迟发性并发症。
