Acute disseminated encephalomyelitis due to hymenoptera stings

Hymenoptera stings can give rise to a variety of conditions. The most common is a self-limiting local allergic reaction, but occasionally they may produce potentially serious systemic reactions. Neurological complications are rare, but very varied and of differing degrees of severity. Some such consequences are those of a demyelinating nature, which can affect the central and/or peripheral nervous system. Their exact pathogenesis remains unknown but an autoimmune mechanism has been suggested. We report the case of a 28-year-old female who had a clinical picture compatible with acute disseminated encephalomyelitis ten days after being stung several times by a bumblebee. The diagnosis was based on findings from magnetic resonance imaging and on the clinical-radiological course after a one-year follow-up. The patient was treated with massive doses of intravenous corticosteroids and immunoglobulins, which brought about partial recovery from the neurological deficit. Hymenoptera stings can produce demyelinating neurological complications, presumably related to the autoimmune system, which could benefit from treatment with immunomodulators such as corticosteroids, immunoglobulins or plasmapheresis.