Death After Bee Venom Apitherapy in Previously Tolerant Patient

The patient suffered a watershed stroke brought on by persistent hypotension during severe anaphylaxis
The patient suffered a watershed stroke brought on by persistent hypotension during severe anaphylaxis

A case report published in the Journal of Investigational Allergology and Clinical Immunology highlights the risks associated with undergoing apitherapy, the practice of using substances from honeybees to treat various medical conditions.

In this case, a 55-year-old woman developed wheezing, dyspnea, and sudden loss of consciousness during her apitherapy session in which she received live bee stings to improve muscular contractures and stress. Of note, she had been attending apitherapy sessions for 2 years prior and had no previous reactions to any kind of hymenoptera.

To aid the patient, clinic personnel administered methylprednisolone (adrenaline was not available) and called an ambulance, which arrived 30 minutes later. At the hospital, a CT scan revealed the patient had suffered a massive watershed stroke brought on by persistent hypotension during severe anaphylaxis. She died several weeks later of multiorgan failure.

Related Articles

Although the patient had been previously tolerant of bee stings, she still developed severe anaphylaxis immediately after being exposed, demonstrating that previous tolerance does not prevent hypersensitivity reaction. In addition, the apitherapy clinic in which she received treatment was not trained appropriately in managing anaphylaxis, as the patient had to wait 30 minutes before receiving intramuscular adrenaline.

"To our knowledge, this is the first reported case of death by bee venom apitherapy due to complications of severe anaphylaxis in a confirmed sensitized patient who was previously tolerant," the authors write. "Our data enable us to conclude that measures to identify sensitized patients at risk should be implemented before each apitherapy sting." Moreover, the authors conclude that the risks associated with apitherapy treatment likely exceed the benefits and therefore believe the practice to be "unsafe and unadvisable."

For more information visit jjaci.org.