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      Síndrome de envenenamento por 2000 picadas de abelhas africanizadas. Relato de caso Translated title: Poisoning syndrome due to 2,000 stings of africanized honeybees

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          Abstract

          JUSTIFICATIVA E OBJETIVOS: As abelhas empregadas inicialmente na produção melífera eram de origem européia, sendo de baixa produtividade e mansas. Em 1956 foram trazidas espécies africanas com maior capacidade produtiva, porém extremamente agressivas. Houve soltura acidental destas abelhas na natureza e ocorreu cruzamento entre as espécies, gerando linhagem de abelhas africanizadas. O objetivo deste relato é sugerir uma padronização de atendimento a pacientes vítimas da síndrome de envenenamento dado o número crescente de casos de ataques maciços por estas abelhas e a literatura escassa sobre o assunto. RELATO DO CASO: Paciente do sexo masculino, 19 anos, que durante treinamento militar foi atacado por enxame de abelhas africanizadas. CONCLUSÕES: As abelhas africanizadas por serem muito agressivas, atacam suas vítimas com elevado numero de picadas inoculando grande quantidade de veneno. As reações às picadas podem variar desde reação inflamatória local em indivíduos não sensibilizados, reação de hipersensibilidade e choque anafilático em indivíduos sensibilizados ou síndrome de envenenamento, quando devido a grande quantidade de veneno inoculado, os efeitos tóxicos se sobrepõem à reação anafilática. O atendimento a este tipo de acidente deve ser o mais precoce possível, com a realização de suporte clínico adequado e remoção mecânica dos ferrões. A estabilização hemodinâmica é de suma importância.

          Translated abstract

          BACKGROUND AND OBJECTIVES: Honeybees first used in the honey production came from Europe. They were gentle but their productivity was very low. In 1956 it was brought from Africa some species of honeybees that were more productible but also extremely aggressive. There was an accidental release of those bees, that proliferated by hybridizing with the European honeybees generating a new specimen of bees: the Africanized honeybees. The objective of this article is to suggest a pattern of treatment for this poisoning syndrome, because of the crescent number of these attacks and a few data about it. CASE REPORT: Male, 19 years old, soldier that in the course of his military training was attacked by a swarm of Africanized honeybees. CONCLUSIONS: As the Africanized honeybees are very aggressive, they attack their victims with lots of stings releasing a large quantity of venom. The reactions to the stings can vary from a local inflammatory reaction in non sensibilized people, hipersensibility reaction and anaphylactic shock in sensibilized people and poisoning syndrome when there is a big amount of inoculated venom. The medical attendance to this kind of accident must be as fast as possible. It must be done an adequate clinical support and a quick mechanical remotion of the stingers. The hemodynamic stabilization is a very important point.

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          Most cited references23

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          Bee and Wasp Venoms

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            ANALYSIS OF 460 FATALITIES FROM VENOMOUS ANIMALS IN THE UNITED STATES

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              Significance of Africanized bees for public health. A review.

              Although massive sting attacks by Africanized bees are currently rare, this type of bee is now endemic in parts of Arizona and Texas, and will probably spread to other warm climate areas in the United States. Treatment of severe toxic reactions to multiple stings usually includes management of shock, hypoxia, and other effects of organ damage. New approaches to reduce blood levels of venom including production of a bee antivenom and hemodialysis require further study. Patients with a trivial allergy to single stings could be at risk from systemic anaphylaxis to multiple bee sting. Those who wish to remain in endemic areas in spite of histories of systemic anaphylaxis to bee stings should be treated with venom immunotherapy, possibly administered more intensively and for longer periods than currently recommended. Continued public education is needed to limit contact with aggressive Africanized bee colonies.
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                Author and article information

                Journal
                rbti
                Revista Brasileira de Terapia Intensiva
                Rev. bras. ter. intensiva
                Associação de Medicina Intensiva Brasileira - AMIB (São Paulo, SP, Brazil )
                0103-507X
                1982-4335
                March 2006
                : 18
                : 1
                : 99-103
                Affiliations
                [01] orgnameHospital Central do Exército orgdiv1CTI
                [02] orgnameAMIB
                [03] orgnameUFRJ orgdiv1FM
                [05] RJ orgnameCentro de Estudos do Hospital Samaritano
                [08] orgnameUFRJ orgdiv1Área Terapia Intensiva
                [06] orgnameHospital Central do Exército
                [04] orgnameInstituto Estadual de Cardiologia do Rio de Janeiro orgdiv1CTI
                [07] orgnameUFRJ orgdiv1FM orgdiv2Departamento de Clínica Médica
                [09] orgnameHospital Universitário Clementino Fraga filho
                Article
                S0103-507X2006000100016 S0103-507X(06)01800116
                10.1590/S0103-507X2006000100016
                14fe4bde-da9c-487a-9989-67ad27e2aa32

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 13 March 2006
                : 02 February 2006
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 5
                Product

                SciELO Brazil

                Categories
                Relato de Caso

                multiple stings,human accident,Africanized honeybees,múltiplas picadas,acidente humano,Abelhas africanizadas

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