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Bee Sting Dysphagia
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Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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TO THE EDITOR:
A 35-year-old man presented to the emergency department with acute dysphagia. He had left a half-filled can of orange soda on a picnic table to continue work and 2 hours later returned for a break. He was drinking the soda through a straw when he developed a foreign-body sensation in the back of his throat accompanied by dysphagia. The patient then vomited, with an unexpected finding of two bees. His symptoms progressed, prompting him to seek urgent medical attention.
On physical examination, the patient was not in acute distress and had normal vital signs. No oral swelling, drooling, or stridor was seen in the oropharynx. His lungs were normal on auscultation. Given the patient's symptoms, emergency esophagastroduodenoscopy was performed. The findings were an extremely erythematous and edematous posterior pharynx with two lesions, presumably bee stings. Mild exudate and erythema were seen in the gastroesophageal junction. No foreign body was found.
Given the acute presentation, the patient was treated with one dose of intravenous solumedrol and was observed in the emergency department. His dysphagia slowly resolved, and he received a 3-day course of steroids.
In a literature review, we found no cases of bee stings causing pharyngeal edema. However, two cases of bees found in the stomach have been reported [1-3]. In these cases, bee stings did not cause pharyngeal edema that resolved after steroid treatment.
Dhiren Shah, MD
Tat-Kin Tsang, MD
Northwestern University Medical School; Evanston, IL 60201
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
