Verdiguel-Sotelo K, Tesoro-Cruz E, Echavarría-Gálvez C, Álvarez-Martínez CG, Zavala MT, Tello-Medina RI

Language: Spanish
References: 11
Page: 162-167
PDF size: 336.39 Kb.

ABSTRACT

Introduction: Cases of insect bites are rare and even more so in the cornea. Objective: to report a case of corneal toxicity secondary to a bee sting. Presentation of case: report of a case and review of the literature. Results: 24-year-old male, with a bee sting in the cornea the right eye, went to primary care for evaluation, an attempt was made to remove the stinger without success. He was sent to the cornea service at the General Hospital of the National Medical Center La Raza, finding a vision of count fingers at 16.40 feets, ciliary injection, cornea with a stinger, doesn't penetrate the anterior chamber, perilesional necrotic tissue, hypopyon level. Stinger removal was retried without success. He was admitted to the operating room for management with debridement of necrotic tissue, reconstructing the corneal surface by an anterior lamellar mini-graft from corneal tissue from a cadaveric donor. In the immediate postoperative visual acuity of 20/400, two months later 20/20. Conclusion: the bee sting in the cornea of human beings is a rare clinical situation that can have devastating complications due to toxicity and immunological effects. The procedure for removing the stinger embedded in the cornea is challenging, as the venom expands. Immediate reconstruction by mini lamellar corneal graft is an effective and timely alternative for the removal of the stinger and the control of the acute disease.

REFERENCES

1. Chen MC, Melnychuk V. Corneal bee sting: improvement in the acute stage in the absence of treatment. Pan Afr Med J. 2020; 37: 54.

2. Ahmed M, Lee CS, McMillan B, Jain P, Wiley L, Odom JV et al. Predicting visual function after an ocular bee sting. Int Ophthalmol. 2019; 39 (7): 1621-1626.

3. Semler-Collery A, Hayek G, Ramadier S, Perone JM. A Case of conjunctival bee sting injury with review of the literature on ocular bee stings. Am J Case Rep. 2019; 20: 1284-1289.

4. Álvarez-Félix JR, Palazuelos-Gaxiola M, Cinco-Sánchez A. Lesión corneal causada por picadura de abeja. Rev Med UAS. 2016; 6 (1): 19-21.

5. Marqués Amat L. Alergia a himenópteros. Medicina Respiratoria. 2010; 3: 17-26.

6. Blanca M. Protocolo diagnóstico y terapéutico de las reacciones alérgicas por picaduras de himenópteros. Medicine. 2009; 10: 2298-2300.

7. Olivo Payne A, Chong E. Bee sting to the cornea: toxic effects and management. Med J Aust. 2018; 209 (4): 155. doi: 10.5694/mja17.01202.

8. Hammel N, Bahar I. Descemet-stripping automated endothelial keratoplasty after bee sting of the cornea. J Cataract Refract Surg. 2011; 37 (9): 1726-1728. doi: 10.1016/j.jcrs.2011.06.020.

9. Gürlü VP, Erda N. Corneal bee sting-induced endothelial changes. Cornea. 2006; 25 (8): 981-983. doi: 10.1097/01.ico.0000226364.57172.72. PMID: 17102681.

10. Smith DG, Roberge RJ. Corneal bee sting with retained stinger. J Emerg Med. 2001;20(2):125-128. doi: 10.1016/s0736-4679(00)00298-5.

11. Gudiseva H, Uddaraju M, Pradhan S, Das M, Mascarenhas J, Srinivasan M et al. Ocular manifestations of isolated corneal bee sting injury, management strategies, and clinical outcomes. Indian J Ophthalmol. 2018; 66: 262-268.