The formation of cataracts has been described after a sting to a site remote from the eye.
+With true anaphylaxis 0.3 mL of a 1:1000 epinephrine solution should be given intravenously.
+Killer bees contain an extremely potent toxin, which can result in death after one sting.
+Serum sickness may develop 2 or 3 days following the sting.
+Treatment of significant reactions to Hymenoptera stings may include epinephrine, antihistamines, and steroids just like any anaphylactic reaction.
The acute local complications of a Hymenoptera sting include swelling and pain. Stings into the eye globe can cause perforation, cataracts, and other long-term complications. A neuropathy can develop if the stinger injects into a peripheral nerve. Killer bees are venomous but the venom has the same potency of other Hymenoptera. Killer bees are fierce and attack in numbers, so death is secondary to the enormous load of toxin delivered by a swarm of bees rather than the potency of the toxin. Systemic anaphylactic reactions can occur in sensitized persons after one sting, but direct toxic reactions can develop in nonsensitized people after multiple stings and include vomiting, syncope, and convulsions. Anaphylaxis is treated with epinephrine, antihistamines, and steroids. In the patient with severe anaphylaxis 1 mL of 1:10,000 epinephrine may be given intravenously. The 1:1000 dilution is reserved for subcutaneous administration. A serum sickness-type illness may develop with fever, arthralgias, and malaise 10 days to 2 weeks following stings.