Patients stung multiple times by killer bees have signs and symptoms of a toxic envenomation, not allergic reactions. The author reviews the signs and symptoms, pathophysiology, and current management of toxic killer bee envenomations.

The northward migration of large swarms of Africanized honeybees (AHBs), or “killer” bees, is responsible for a unique phenomenon that has not previously been experienced in the United States. More and more patients are coming to emergency departments and hospitals in the Southwest and South because of killer bee attacks. These patients, stung multiple times by the bees, have signs and symptoms of a toxic envenomation, not allergic reactions. Deaths from AHBs are a result of direct toxic effects, not anaphylaxis.1 The care of patients admitted to critical care units with toxic bee envenomations poses an unusual challenge for critical care nurses because this...

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