Clinical Spectrum of Patients Admitted with Hymenoptera (Bees and Wasps) Stings in a Medical College Hospital of Himachal Pradesh, India

J Assoc Physicians India. 2023 Oct;71(10):57-63. doi: 10.59556/japi.71.0347.

Abstract

Objective: Hymenoptera (bees and wasps) stings are a common health hazard in the tropics, particularly in rural areas. The study was planned to describe the clinical spectrum of patients with Hymenoptera (bees and wasps) stings admitted to a medical college hospital in Himachal Pradesh, India. Materials and methods: This was a hospital-based open cohort prospective study conducted on patients admitted with a history of Hymenoptera (bees and wasps) stings. The study period was 1 year, and patients were recruited using a nonprobability sampling method. Demography, clinical and laboratory data, complications, and outcomes were recorded and analyzed. Systemic allergic reactions were classified according to the British Society for Allergy and Clinical Immunology (BSACI) guidelines. Results: A total of 44 patients (25 males and 19 females) were included in the study. All the patients reported in the warmer months from April to November were stung between 6 am and 8 pm and reported within three from the time of the incident. The most common local symptoms of pain and pruritus were reported by 100 and 31.8% of patients, respectively. Features of systemic envenomation reported were dizziness, nausea, vomiting, decreased urine output, hematuria and cola-colored urine, pain abdomen, cough, and wheezing. On examination, local redness and swelling were observed at 100 and 72.7%, respectively. The size of swellings was <10 cm in all of the patients. As per BSACI guidelines, the severity of systemic allergic reactions was mild, moderate, and severe in 70.4, 13.6, and 15.9%, respectively. Transaminases were observed in 40.9% of patients. Acute kidney injury (AKI) developed in 22.7% of patients. The mortality was 4.5% in this study. Conclusion: This is one of the largest studies on Hymenoptera envenomation in India and contributes to our understanding of the subject. How to cite this article: KP MS, Raina S, Kaul R, et al. Clinical Spectrum of Patients Admitted with Hymenoptera (Bees and Wasps) Stings in a Medical College Hospital of Himachal Pradesh, India. J Assoc Physicians India 2023;71(10):57-63.

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Female
  • Humans
  • Hymenoptera
  • India / epidemiology
  • Insect Bites and Stings* / complications
  • Insect Bites and Stings* / epidemiology
  • Male
  • Middle Aged
  • Prospective Studies
  • Wasps
  • Young Adult