Management of Corneal Bee Sting Injuries
| Autor: | Thanos D. Papakostas, Robert Dunphy, Luis Alonso Gonzalez-Gonzalez, Lisa Fanciullo, Mary K. Daly, Tulay Cakiner-Egilmez, Donna Siracuse-Lee, Ruju R Rai |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Corneal Pachymetry Administration Topical Visual Acuity Infectious Keratitis Keratitis Cornea 03 medical and health sciences 0302 clinical medicine Edema Medicine Humans 030212 general & internal medicine Glucocorticoids business.industry Stinger Insect Bites and Stings General Medicine Middle Aged medicine.disease Bee stings eye diseases Surgery Anti-Bacterial Agents Ophthalmology Sting medicine.anatomical_structure Eye Foreign Bodies Concomitant 030221 ophthalmology & optometry Drug Therapy Combination medicine.symptom business Tomography Optical Coherence Corneal Injuries Follow-Up Studies |
| Zdroj: | Seminars in ophthalmology. 32(2) |
| ISSN: | 1744-5205 |
| Popis: | To review the management of keratitis after corneal bee stings and to report a case of deep stromal corneal infiltrate secondary to a retained bee stinger managed conservatively in a patient who presented three days after unsanitary manipulation of the stinger apparatus.Case report and review of literature.A 57-year-old male beekeeper was evaluated for pain, blurry vision, and photosensitivity after a corneal bee sting. Of note, the venom sac had been removed with dirty tweezers three days prior to his visit. On exam, a focal infiltrate with diffuse edema was seen surrounding a retained bee stinger in the peripheral cornea. Trace cells in the anterior chamber were also noted. Based on a high suspicion for infectious keratitis, a conservative treatment strategy was elected. Administration of broad-spectrum topical antibiotics with concomitant abstention of corticosteroids led to rapid resolution of the symptoms. Over 16 months of follow-up, the stinger has remained in situ without migration and the patient has maintained 20/20 visual acuity without complications. There is debate on the preferred method for the management of corneal injury secondary to bee stings, especially when it is associated with a retained stinger. We herein present our findings in our appraisal of reported cases.In the aftermath of an ocular bee sting, close surveillance for inflammation and infection is essential. Individual manifestations of these injuries vary in timing, type, and severity; therefore, the accessibility of the stinger and the evolving clinical picture should guide therapeutic decisions. |
| Databáze: | OpenAIRE |
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