LETTER
Bee Sting Dysphagia
Dhiren Shah, MD, and
Tat-Kin Tsang, MD
1 August 1998 | Volume 129 Issue 3 | Page 253
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.
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Author and Article Information
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Northwestern University Medical School; Evanston, IL 60201
1. Lynch JP, Rothstein RD. A gastric "bee-zoar." N Engl J Med. 1997; 336:1763-4.
2. Girardi A. The bee: an unusual gastric foreign body [Letter]. Endoscopy. 1990; 22:240.
3. Butterton JR, Clawson-Simons J. Hymenoptera uvulitis [Letter]. N Engl J Med. 1987; 317:1291.
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