Table 1.
Complications associated with honeybee stings envenoming.
| System/Organ | Clinical complications | Reference |
|---|---|---|
| Cardiovascular | Acute myocardial ischemia | (107–109) |
| Acute myocardial injury | (110) | |
| Atrial fibrillation | (111) | |
| Hypertension | (112, 113) | |
| Kounis syndrome (KS) | (111, 114–120) | |
| Left ventricular hypertrophy | (121) | |
| Left ventricular systolic dysfunction | (108, 122) | |
| Mobitz type 2 heart block | (123) | |
| Myocardial damage | (112, 124) | |
| Pericardial effusion | (125) | |
| Pericarditis epistenocardica | (126) | |
| Subendocardial hemorrhage | (121) | |
| Takotsubo cardiomyopathy | (127) | |
| Digestory | Boerhaave’s syndrome | (107) |
| Gastrointestinal hemorrhage | (113, 128) | |
| Hematologic | Acute limb ischemia | (129) |
| Acute femoral thrombosis | (129) | |
| Anemia | (130) | |
| Bleeding | (4) | |
| Brachial artery thrombosis | (131) | |
| Deep vein thrombosis (DVT) | (132) | |
| Disseminated intravascular coagulation | (112) | |
| Hematochezia | (133) | |
| Hemolysis | (29, 91, 112, 134) | |
| Shock | (18, 112, 125, 135, 136) | |
| Thrombotic microangiopathy | (91) | |
| Thrombotic thrombocytopenic purpura (TTP) | (137) | |
| Hepatic | Acute liver injury | (91) |
| Adrenal hemorrhage | (138) | |
| Hepatic damage | (124) | |
| Hepatic dysfunction | (29, 112) | |
| Ischemic hepatitis | (133) | |
| Immune | Anaphylactic shock | (4, 73, 107, 108, 114, 121, 122, 133, 139–143) |
| Mast cell activation syndrome | (116) | |
| Multisystem | Cardiopulmonary arrest | (143) |
| Multiorgan failure | (79, 92, 134, 136, 144–146) | |
| Multiorgan injury | (147) | |
| Muscular | Hemiparesis | (148, 149) |
| Rhabdomyolysis | (18, 29, 112, 135, 148, 150–155) | |
| Nervous | Acute bilateral cerebellar infarction | (156) |
| Axonal motor polyneuropathy | (157, 158) | |
| Cavernous sinus thrombosis | (159) | |
| Coma | (112, 136) | |
| Convulsion | (159) | |
| Encephalitis | (128) | |
| Guillain-Barre syndrome | (160) | |
| Hemorrhagic/Ischemic stroke | (134, 136, 148, 149, 161–165) | |
| Intracerebral hemorrhage | (136) | |
| Multiple acute cerebral infarcts | (148, 149, 159) | |
| Subarachnoid hemorrhage | (4, 121, 149) | |
| Subdural hemorrhage | (149) | |
| Tonsillar herniation | (133) | |
| Transcortical motor aphasia | (166) | |
| Renal | Acute kidney injury | (29, 91, 108, 113, 135, 150, 153, 155, 159, 167) |
| Acute kidney failure | (18, 112, 134, 136, 147, 148, 151, 154) | |
| Respiratory | Acute pulmonary emphysema | (141) |
| Acute respiratory distress syndrome (ARDS) | (18, 112, 115, 125, 134, 135, 168) | |
| Bronchial obstruction | (141) | |
| Laryngeal congestion | (138) | |
| Laryngeal edema | (138, 139) | |
| Pulmonary congestion | (139, 141, 169) | |
| Pulmonary edema | (113, 125, 127, 139, 141) | |
| Pulmonary hemorrhage | (141) | |
| Traquea congestion | (138) | |
| Traquea edema | (138) | |
| Skin | Angioedema | (169, 170) |
| Grover’s Disease (GD) | (171) | |
| Urinary | Anuria | (115, 125) |
| Hematuria | (130, 133) | |
| Hemoglobinuria | (29) | |
| Visual | Cataract | (172, 173) |
| Central retinal artery occlusion (CRAO) | (124, 140) | |
| Conjunctival chemosis | (136, 174–178) | |
| Conjunctival congestion | (172) | |
| Conjunctival hyperemia | (177–179) | |
| Conjunctival injection | (175) | |
| Conjunctival ischemia | (175) | |
| Corneal abrasions | (179–182) | |
| Corneal decompensation | (172) | |
| Corneal edema | (172, 175, 181, 183–186) | |
| Cornea epithelial defect | (172) | |
| Corneal infiltration | (172, 175, 180) | |
| Corneal scarring | (172, 186) | |
| Descemet membrane fold | (174) | |
| Endophthalmitis | (184, 187) | |
| Episcleral hyperemia | (178) | |
| Eyelid edema | (175, 179) | |
| Glaucoma | (172) | |
| Keratoconjunctivitis | (188) | |
| Keratopathy | (180, 186) | |
| Optic disc hyperemia | (189) | |
| Optic neuritis | (190) | |
| Optic neuropathy | (185) | |
| Retinal striae | (189) | |
| Scleritis | (184) | |
| Striate keratopathy | (177) | |
| Subconjunctival hemorrhage | (176, 185, 187) | |
| Uveitis | (189, 191) | |
| Vitritis | (189) |