Giant honey bee (Apis dorsata) sting and acute limb ischemia: a case report and review of the literature

BACKGROUND: Clinically significant manifestations of Hymenopteran envenomation is increasingly recognized in Sri Lanka. These clinical manifestations range from localized allergic reactions to end-organ failure and thrombotic-episodes. We report a case of 65 year old male who developed acute lower limb ischaemia after a sting of the hymenopteran Apis dorsata. CASE PRESENTATION: A 65 year old male with hypertension and hyperlipidaemia presented with envenomation from an attack of a swarm of A. dorsata. He subsequently developed acute limb ischaemia following an acute femoral thrombus and made a complete recovery with anticoagulation and surgical-embolectomy. CONCLUSIONS: This case adds to the spectrum of thrombotic manifestations of Hymenopteran venom highlighting the requirement for close monitoring and clinical vigilance in these patients.