Honey bee sting deaths at medicolegal autopsy: A case series demonstrating variable manifestations of anaphylactic fatality.
Krishna Nishad, Tauheed Anwar, Sneh Sahani et al.
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Case in brief
Three people in Lucknow, India, died after rapid collapse following honey bee attacks. At medicolegal autopsy, sting burdens ranged from limited exposure to an estimated 200 stings. Findings varied: one case had facial edema and generalized congestion without significant airway or pulmonary edema; another had tracheobronchial froth and markedly heavy, edematous lungs; and the third had severe epiglottic and laryngeal edema with luminal narrowing, froth, and marked pulmonary edema. The cases illustrate differing autopsy appearances in fatal reactions and the need to interpret findings alongside the circumstances and history of the attack.
What made this case unusual
Fatal reactions showed markedly variable airway and lung findings across sting burdens, including severe laryngeal narrowing in one case but no significant upper-airway or pulmonary edema in another.
Diagnostic / clinical pearl
Autopsy findings may be subtle or nonspecific in fatal bee sting reactions. Integrate scene evidence, witness history, sting distribution, and focused airway examination when assessing the cause of death.