It was supposed to be a nice refreshing run along a country road.
Explore This IssueACEP Now: Vol 36 – No 03 – March 2017
On my return loop, about a mile from my house, I felt an insect fly into my mouth. I immediately coughed it out and was a little surprised when I saw that it was not just a regular house fly—it had some yellow stripes on it. Nonetheless, I was having a good run and didn’t feel like stopping to take a better look. “Even if it was a bee or a wasp,” I thought to myself as I kept running, “thank God I’m not allergic.”
Literally 30 seconds later, I started to feel intense pain in the back of my throat, much like a sore throat from hell. Granted, even though I am more out of shape now than I used to be, it started feeling like it was getting harder to breathe.
A few scenarios started running through my head:
- If my throat closes, at least I’ll be by a bigger road soon and somebody will see me.
- I wonder how long the paramedics will take to get to my rural house.
- I’m not that far from home. I know I have a scalpel, a bougie, and an endotracheal tube somewhere.
I managed to get home and took a cursory look at the back of my throat. My posterior pharynx was quite erythematous, but most noticeably, my uvula was the size of my thumb (see Figure 1)! Thankfully I wasn’t having any other symptoms except throat pain and massive uvular edema. I drank a glass of cold water to see if it would help, but I was still in a lot of pain. I closely reexamined my uvula and noticed a small black foreign body that was embedded in the mucosa. I thought to myself, “Could that really be what I think it is?” I grabbed some tweezers, gave it a tug, and sure enough, out came a bee stinger with an attached empty venom sac (see Figure 2). I quickly decided it might be best to be in a health care environment in case things got worse. I threw Betadine, a scalpel, a bougie, and an endotracheal tube in the front seat of my car and drove to the hospital.
The Buzz on Bee Stings
Hymenoptera are stinging insects that are grouped into three families: Apidae (honeybees, bumblebees), Vespidae (wasps, hornets, yellow jackets), and Formicidae (ants).1 Bee stingers have microscopic barbs that keep the stinger buried in tissue. When the bee flies away, the stinger is avulsed (along with part of the abdomen), and the bee eventually dies. Therefore, bees can only sting once. Wasps, on the other hand, have smooth stingers that allow them to sting a victim several times.