Bee Sting

Bee sting is relatively common in summer months; the same applies to wasp or hornet sting. The venom of a bee is not very strong, but despite that it can cause serious complications including death.


A bee (wasp, hornet) sting causes that a small dose of venom gets into our bloodstream. The venom can react in two major ways.


First, the poison acts as a toxic substance directly damaging the tissue. In wasps, the venom also contains a substance known as the histamine that causes pain and redness of the affected area. One sting is, however, very weak and there is not enough toxin to threaten human’s life. However, large amount of the bee venom (hundreds or even thousands of stings) can easily endanger life or cause death.


The venom is also a potent allergen, i.e. substance that frequently causes allergic reactions. This is a major problem as even the deadly type of allergic reaction known as anaphylactic shock may occur due to a single sting. The immune reaction includes releasing of histamine molecules from so-called mast cells. The details about the course of allergic reactions can be found in the relevant text.


Summary: The effect of the venom itself depends on the dose, while the allergic reaction is independent on the dose. The effects of the poison itself are similar in each person, while the allergic reaction occurs only in certain individuals.


There are more possible situations:

One or few stings without allergic reaction

This is the most common situation, which manifests with local pain, redness and swelling around the site of the sting. This may be dangerous only when the sting affects some inappropriate places, such as the tongue. Swelling and enlargement of the tongue may obstruct the airways and threaten the patient with suffocation.

A large number of stings (tens to hundreds) without allergic reaction

Large amount of the venom damages cells and increases the permeability of blood capillaries. The symptoms may include pulmonary edema and circulatory failure. The condition is by its symptoms very similar to the anaphylactic shock.

One or more stings associated with allergic reaction

Weaker allergic reaction may just increase the local swelling or it causes allergic urticaria. Other possible manifestations include asthma or even anaphylactic shock. Information about these conditions can be found in the relevant texts.


The diagnosis is clear from information about the sting and presence of any of those mentioned symptoms.


In a single or few stings, it is best to cool the affected area (against swelling) and small dose of antihistaminics may also help. The antihistaminics are anti-allergic drugs acting against the effects of histamine. Antihistaminics can be administered in forms of tablets or local ointments. If the sting hit the tongue, it is advisable to quickly visit a doctor. Patients who suffered hundreds of stings should be immediately transported to the nearest hospital. Severe allergic reactions should be treated by stronger immunosuppressive drugs such as the corticosteroids or by epinephrine applied intramuscularly. People who have experienced anaphylactic shock in the past should be equipped with special dose of epinephrine prepared for rapid application. Epinephrine counteracts the effects of histamine and thus it can block or at least reduce the development of allergic reactions.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources