Transient ischemic liver injury and respiratory failure in a COVID-19-positive patient after multiple bee stings
Onder Yesiloglu1
, Ahmet Sonmez1, Begum Seyda Avci2, Hilmi Erdem Sumbul2, Akkan Avci1
1Emergency Medicine Clinic, Gaziantep 25 Aralik State Hospital, Adana, Turkey
2Department of Emergency Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Turkey
3Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Turkey
Keywords: Acute hepatitis, bee sting, bee venom, COVID‑19, liver injury, severe acute respiratory syndrome coronavirus-2
Abstract
We present a patient with multiple bee stings who developed lung and liver injuries and subsequently tested positive for coronavirus disease 2019 (COVID-19). A 65-year-old male patient presented to the emergency department after being stung by more than 100 honeybees. His physical examination revealed pustular lesions distributed across his chest, arms, back, legs, and head, marking the sting zones. While the patient had no history of liver disease, initial laboratory test results showed elevated liver enzyme levels. A chest computer tomography scan was ordered, revealing bilateral ground glass opacities suggesting COVID 19. His condition worsened over the course of the following day, and when he was admitted to the intensive care unit (ICU), his SpO2 decreased to 83% despite oxygen support with a mask. The second polymerase chain reaction test taken in the ICU was positive for COVID 19 infection. After stung with multiple bees, the patient developed acute liver injury and suffered from concomitant COVID 19 related respiratory insufficency, and he was treated accordingly. Starting on the 5th day, the patient’s liver markers began to improve, and on the 13th day, he was discharged with normal vital signs and liver enzyme values. There seem to be varying outcomes across different studies with regard to the relationship between bee stings and COVID 19. Further research is needed to explore the possibility of this complementary treatment with bee venom in the prevention of severe acute respiratory syndrome coronavirus-2 infection.
How to cite this article: Yesiloglu O, Sonmez A, Avci BS, Sumbul HE, Avci A. Transient ischemic liver injury and respiratory failure in a COVID-19-positive patient after multiple bee stings. Turk J Emerg Med 2023;23:57-60.
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