@article{ref1,
title="Bee sting envenomation severe cases in Manaus, Brazilian Amazon: clinical characteristics and immune markers of case reports",
journal="Revista da Sociedade Brasileira de Medicina Tropical",
year="2020",
author="Mendonça-da-Silva, Iran and Monteiro, Wuelton Marcelo and Sachett, Jacqueline Almeida Gonçalves and Barbosa, Endila Souza and Cordeiro-Dos-Santos, Marcelo and Lacerda, Marcus Vinícius Guimarães and Melo, Gisely Cardoso and Costa, Allyson Guimarães and Val, Fernando Fonseca Almeida",
volume="54",
number="",
pages="e20200319-e20200319",
abstract="Bee venom is a natural toxin composed of several peptides. Massive envenoming causes severe local and systemic reactions. We report two cases of severe bee envenomation, of which one was fatal. We also describe clinical characteristics and immune markers. Both victims suffered from respiratory distress, renal failure, rhabdomyolysis, and shock. They required invasive mechanical ventilation, vasoactive drugs, and renal replacement therapy. Moreover, serum levels of chemokines, cytokines, and cell-free circulating nucleic acids demonstrated an intense inflammatory process. Massive envenoming produced systemic injury in the victims, with an uncontrolled inflammatory response, and a more significant chemotactic response in the fatal case.<p /> <p>Language: en</p>",
language="en",
issn="0037-8682",
doi="10.1590/0037-8682-0319-2021",
url="http://dx.doi.org/10.1590/0037-8682-0319-2021"
}