Fatal Anaphylaxis Following Multiple Hornet Stings: A Case Report

Area of Science:

• Forensic Pathology
• Toxicology
• Allergy and Immunology

Background:

• Fatal anaphylaxis from Hymenoptera stings presents diagnostic challenges postmortem.
• Lack of specific pathological findings and postmortem biochemical marker changes complicate diagnosis.

Purpose of the Study:

• To report a rare forensic case of fatal anaphylaxis due to multiple hornet stings.
• To highlight the importance of integrating multiple data sources for accurate postmortem diagnosis.

Main Methods:

• Case report of a 79-year-old woman with numerous hornet stings.
• Autopsy findings including laryngeal edema and subcutaneous hemorrhage.
• Postmortem femoral blood analysis for tryptase and histamine levels.

Main Results:

• Autopsy revealed severe laryngeal edema and hemorrhage at sting sites.
• Elevated postmortem serum tryptase and histamine indicated mast cell degranulation.
• Toxic envenomation was excluded due to biochemical profile and lack of organ damage.

Conclusions:

• Postmortem diagnosis of fatal anaphylaxis requires integrating scene, autopsy, and biochemical data.
• This approach aids in differentiating anaphylaxis from venom toxicity in sting-related deaths.
• The study proposes an efficient method for diagnosing complex sting-related fatalities.