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Can A Bee Sting Cause A Stroke?

Medically reviewed by Susan Kerrigan, MD and Marianne Madsen on February 3, 2023
Additions/comments by Neurologist Steve Schadendorf, MD

A 41-year old woman was working in her field when she was stung by a honeybee. Seven days later she was dead. Although dying from a bee sting is not uncommon, her case was unusual. Rather than dying from an allergic reaction, she suffered a stroke and died from ensuing complications. So was the bee sting responsible? And despite bee venom’s dangers, does this toxic substance have benefits as well?

 

Deadly Stings

 

Every year, around 60 people die in the U.S. from bee or wasp stings. The vast majority are men, who are often working in trees or on ladders when they accidentally disturb a nest. According to the Centers for Disease Control and Prevention, the number of sting-related deaths is on the rise. Bee venom contains a mixture of biologically active enzymes, amines, and proteins that can affect both skin cells and the immune system. Because individuals have different reactions a bee sting can cause a host of medical issues. Most people experience a small, red welt after being stung. Some suffer more moderate reactions––like increasing swelling at the site of the sting for a day or more. Unfortunately, a few people experience severe reactions which include difficulty breathing, swelling of the throat and tongue, and even loss of consciousness. Anaphylactic reactions can lead to shock or even death. Half of the people who experience severe reactions had only mild reactions during previous stings. Between 25% to 65% of people who have a severe reaction will have another one if they are stung again. This is why they need to take precautions, including venom immunotherapy (where resistance to venom is slowly built up through controlled injections), and carrying epinephrine/adrenaline auto-injectors.

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Stroke: Causes

Stroke: Causes

The woman stung by a honeybee in her field was unusual. After her forearm began swelling, she went to a nearby hospital and was administered intravenous antihistaminics and steroids. Three hours after being stung, she suffered generalized tonic clonic seizure (once known as a grand mal seizure). Although often associated with epilepsy, in this woman’s case, it was an ischemic stroke––a blood clot had blocked a blood vessel in her brain. The woman lost consciousness. The next day, she was moved to another hospital where her brain’s magnetic resonance imaging (MRI) showed infarcts in her left temporal lobe––dead tissue. She’d also suffered what is known as a hemorrhagic transformation. Affecting around 10% of those who suffer an ischemic stroke, it meant blood was flowing into the affected area. Although she suffered a number of complications, the primary cause of death was hemorrhagic stroke due to disseminated intravascular coagulation or abnormal, excessive blood clotting.

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Ischemic Stroke

Ischemic Stroke

Because a brain hemorrhage can be induced by honeybee venom, strokes, while rare, are a real risk. Even if you have never had an allergic episode, it’s important to take precautions. The woman who died had never had a reaction and was a nonsmoker in good health without a family history of strokes. Still, despite its dangers, an alternative therapy known as apitherapy uses bee venom delivered by either a manual injection or a sting. Since beekeepers have a lower incidence of rheumatoid arthritis, the venom’s anti-inflammatory qualities may be responsible. Studies have discovered numerous benefits to the practice which goes back thousands of years. The drawback is the high percentage of subjects reporting side effects.

 

Cases like this woman in Scotland and the scores who die each year from stings focuses attention on how bees harm people. Less attention is given to the millions of bees that die from human interactions. Clearly we hurt them far more than they hurt us. After all, a honeybee can only sting once.

 

Written by John Bankston

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