Among the human pathologies produced by venomous animals, bee stings constitute the largest number of accidents in several countries, exceeding the mortality rate caused by other venomous animals such as snakes, spiders or scorpions. The clinical picture after the bee sting may include anaphylaxis or poisoning. The latter is produced by massive attacks and is a serious problem that may put the patient's life at risk. People that are poisoned display hemolysis, rhabdomiolysis and acute renal failure that together with other systemic failures can bring about death. The knowledge of the physiopathological mechanisms involved in the massive attack of bees is crucial for health care professionals as to date we do not ha ve antivenoms with proven clinical efficacy. In this review we include the bee's biological aspects, venom composition and its relation with the occurrence and severity of accidents as well as epidemiological data that can be useful for this type of accidents

Dentro de las patologías humanas producidas por animales con la capacidad de inocular veneno, las picaduras de abeja producen el mayor número de accidentes por animales en muchos países, superando a menudo en mortalidad a los producidos por serpientes, escorpiones y arañas. El cuadro clínico por la picadura de estos himenópteros puede consistir en fenómenos alérgicos o en cuadros de envenenamiento. Estos últimos se producen por el ataque de enjambres constituyendo un hecho grave que puede comprometer la vida. En el sujeto envenenado pueden observarse hemólisis, rabdomiólisis e insuficiencia renal, que junto a otras alteraciones sistémicas pueden conducir a la muerte. El conocimiento de los acontecimientos fisiopatológicos que se producen ante los ataques masivos de abejas es de suma importancia para el personal de salud dado que hasta la fecha no existen antivenenos que hayan demostrado tener eficacia clínica comprobada. En esta revisión se consideran los aspectos biológicos de las abejas y de la composición de su veneno relacionado con la ocurrencia y severidad de los accidentes, así como datos epidemiológicos de utilidad para enfrentarse a este tipo de cuadro.

Blood samples of 50 healthy specimens from each of the following species: Bothrops alternatus, Bothrops jararacussu, Bothrops moojeni, and Bothrops neuwiedi diporus all kept in captivity were taken to determine the hematocrit (PCV) value, red blood cell count (RBC), total leukocyte (WBC) and differential leukocyte count, thrombocyte count, mean corpuscular volume (MCV), hemoglobin concentration (HbC), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). These hematological parameters were compared to those obtained from other Bothrops species. PCV values, RBC, hemoglobin, WBC count, and differential leukocyte count are within the range of values reported for other Bothrops species, while the thrombocyte count was significantly lower. All the hematological parameters obtained from the four studied Bothrops species were higher than those described for B. ammodytoides.

The immunochemical reactivity and neutralizing capacity of polyvalent Vipera antivenom (Vipera ammodytes, Vipera aspis, Vipera berus, Vipera lebetina, and Vipera xanthina) were tested on the enzymatic and biological activities of Crotalus durissus terrificus and the following Bothrops venoms from Argentina (Bothrops alternatus, Bothrops ammodytoides, Bothrops neuwiedii, Bothrops jararaca, Bothrops jararacussu, and Bothrops moojeni). The Vipera antivenom reacted weakly when tested by double immunoprecipitation (DIP) and reacted with all the venoms when tested by ELISA. Several components in all the venoms studied were recognized in Western blots. Vipera antivenom deactivated to different degrees in vitro procoagulant, (indirect) hemolytic, and proteolytic activities in all the venoms studied. Preincubation of Bothrops alternatus venom with Vipera antivenom neutralized a lethal potency of 4.5 LD50 in mice with an ED50 of 1.25 <FONT FACE="Symbol">±</FONT> 0.25 <FONT FACE="Symbol">m</FONT>l per <FONT FACE="Symbol">m</FONT>g of venom, and with 1.0 <FONT FACE="Symbol">m</FONT>l/<FONT FACE="Symbol">m</FONT>g inhibited 54% of the hemorragic activity and 48% of necrotic activity. Vipera antivenom (2.0 <FONT FACE="Symbol">m</FONT>l per <FONT FACE="Symbol">m</FONT>g toxin) inhibited the phospholipase A2 activity of purified crotoxin and decreased its lethal potency by 60%, while the neutralizing capacity on the lethal potency of crude Crotalus durissus terrificus venom was poor even at a level of 5.0 <FONT FACE="Symbol">m</FONT>l/<FONT FACE="Symbol">m</FONT>g of venom.