Anaphylactic death due to multiple bee stings - A Case report

Abstract

Among the unnatural deaths, those occurring due to insect bites are uncommon and fatality due to bee sting is even rare. Though bee stings may be routinely encountered, specifically among rural population residing in close proximity to dense forests, they are rarely seen in urban areas. But, Chandigarh, even though an urban area, but having one of the highest 'green cover' in the country, is not a stranger to bee sting cases. In most of the cases, the sting causes local reaction; occasionally, a life threatening anaphylaxis may occur leading to death. In general, multiple bee stings are rare, may be caused by a particular group of so called 'Africanized' honeybees, as they usually attack in a swarm. Deaths due to massive envenomation have also been reported in literature among the affected individuals. Fatality in such cases is attributed to systemic anaphylactic shock, suffocation, worsening of pre-existing disease or Disseminated Intravascular Coagulation (DIC) following multisystem involvement. Here, we report a case of death due to anaphylactic shock following multiple bee sting injuries caused by a swarm of bees. The associated postmortem features of anaphylaxis, various methods and their significance of establishing the diagnosis are also discussed.