Aortic prosthetic graft thrombosis after bee sting-induced anaphylaxis

TL;DR

A bee sting caused a severe allergic reaction and blood clot in a man's aortic graft, leading to emergency surgery and recovery.

Contribution

This case highlights a novel link between hymenoptera venom and prosthetic graft thrombosis through synergistic mechanisms.

Findings

Anaphylaxis from a bee sting led to rapid thrombosis of an aortic graft.

Emergency bypass surgery restored limb perfusion but caused postoperative complications.

The case suggests hymenoptera venom can trigger graft occlusion via thrombogenic pathways.

Abstract

Hymenoptera stings may cause severe cardiovascular events through direct prothrombotic venom effects and anaphylaxis-related hemodynamic collapse. We report the case of a 62-year-old male beekeeper with an infrarenal aortoaortic prosthetic graft who developed grade 3 anaphylaxis after a bee sting. Within 2 hours, he experienced bilateral lower limb paresthesia and severe pain. Computed tomography angiography revealed complete graft thrombosis extending into the left iliac axis. Emergency axillobifemoral bypass restored perfusion. Postoperative complications included compartment syndrome, acute kidney injury, and rhabdomyolysis, all resolving favorably. This case illustrates that hymenoptera venom can precipitate prosthetic graft occlusion through synergistic thrombogenic pathways, warranting preventive strategies and close monitoring in high-risk patients.

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