MANUAL MINORS
Bee stings occur when a bee injects venom through its stinger. Unlike wasps, bees leave their stinger embedded in the skin, which can cause continuous venom release if not promptly removed.
Bee stings cause an immediate local reaction with pain, swelling, and redness. In some individuals, especially those allergic to bee stings, it can trigger an anaphylactic reaction, a potentially life-threatening medical emergency.
Diagnosis
Diagnosis is based on the presence of a visible stinger at the sting site, along with local symptoms like sharp pain, redness, and swelling. In allergic individuals, systemic symptoms such as hives, difficulty breathing, facial or throat swelling, dizziness, and, in extreme cases, anaphylactic shock may develop. It is crucial to evaluate the patient’s history for previous allergic reactions to insect stings.
Differential Diagnosis
Condition | Key Difference |
|---|---|
Wasp sting | Does not leave the stinger embedded and can sting multiple times. |
Cellulitis | Skin infection that can develop after a sting if not properly treated. |
Urticaria | Allergic skin reaction that can mimic anaphylaxis, but without recent sting history. |
Toxic reaction | Result of multiple stings with generalised symptoms, not a true allergy. |
Emergency Management
Initial emergency management includes the immediate removal of the stinger, preferably by scraping it off with a flat object (such as a credit card) to avoid squeezing more venom into the skin. The area should be washed with soap and water, and ice should be applied to reduce pain and swelling. Oral antihistamines, such as diphenhydramine, help relieve itching, while NSAIDs can be used for pain.
If the patient shows signs of anaphylaxis (e.g., difficulty breathing, facial or tongue swelling, dizziness), intramuscular adrenaline should be administered immediately, and the patient should be transferred to the hospital for advanced care.
Definitive Treatment
For mild stings, definitive treatment includes symptomatic management with antihistamines and analgesics, along with home follow-up. For patients with severe allergic reactions, an epinephrine auto-injector is prescribed for future emergencies, and consultation with an allergist is recommended to assess the possibility of immunotherapy. Education on preventing future stings and the proper use of the auto-injector is essential to avoid serious complications in the future.
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