<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0026-1742</journal-id>
<journal-title><![CDATA[Revista de la Facultad de Medicina (México)]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Fac. Med. (Méx.)]]></abbrev-journal-title>
<issn>0026-1742</issn>
<publisher>
<publisher-name><![CDATA[Universidad Nacional Autónoma de México, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0026-17422018000300031</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Falla multiorgánica secundaria a múltiples picaduras de abeja (Apis mellifera). Reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Multiorgan failure secondary to multiple bee stings (Apis mellifera). Case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Izaguirre González]]></surname>
<given-names><![CDATA[Allan Iván]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Zepeda]]></surname>
<given-names><![CDATA[Erick Rodolfo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivas-Godoy]]></surname>
<given-names><![CDATA[Alexis Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-Sierra]]></surname>
<given-names><![CDATA[Luis Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Robbio]]></surname>
<given-names><![CDATA[Iván]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro de Salud Integral (CIS)-Amigos de las Américas  ]]></institution>
<addr-line><![CDATA[Trojes El Paraíso]]></addr-line>
<country>Honduras</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Escuela Universitario.  ]]></institution>
<addr-line><![CDATA[Tegucigalpa ]]></addr-line>
<country>Honduras</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Nacional Autónoma de Honduras (UNAH) Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[Tegucigalpa ]]></addr-line>
<country>Honduras</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Clínicas Médicas Emanuel  ]]></institution>
<addr-line><![CDATA[Comayagua ]]></addr-line>
<country>Honduras</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2018</year>
</pub-date>
<volume>61</volume>
<numero>3</numero>
<fpage>31</fpage>
<lpage>37</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0026-17422018000300031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0026-17422018000300031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0026-17422018000300031&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: Las picaduras de abejas producen el mayor número de accidentes en muchos países. Se han descrito manifestaciones sistémicas inusuales tras la exposición al veneno de himenópteros. Con menor frecuencia se han documentado complicaciones neurológicas, infarto del miocardio, rabdomiólisis e insuficiencia renal. Este tipo de reacciones alérgicas sistémicas se producen en 0.3-7.5% de la población.  Caso clínico: Varón de 39 años, talador, procedente de zona rural de Comayagua, Honduras, con historia de sufrir múltiples picaduras por abeja (Apis mellifera) acompañado de síncope, con trauma en región frontoparietal bilateral, de 3 h de evolución, fue atendido en servicio de salud en Comayagua y trasladado al Hospital Escuela Universitario, donde se continuó manejo por anafilaxia severa y extracción de múltiples aguijones. Posteriormente inició con estridor laríngeo, cianosis y disnea, por lo que se realizó intubación endotraqueal. Al examen físico se identificó edema facial importante, múltiples lesiones y excoriaciones, patrón respiratorio irregular, picaduras generalizadas, y presencia de hipoventilación en ambos campos pulmonares. Glasgow 13/15, hiperalgesia generalizada. Exámenes de laboratorio mostraron reacción leucemoide, neutrofilia severa, hiperhemoglobinemia, aumento de azoados, enzimas hepáticas elevadas, hipoalbuminemia, trastornos hidroelectrolíticos y acidosis mixta. Posteriormente progresó a rabdomiólisis y falla multiorgánica (hemodinámica, ventilatoria, renal), y falleció 48 h después de su ingreso.  Conclusión: El número de picaduras y la cantidad de veneno inoculado son factores predictores de alta mortalidad y baja sobrevida. El traslado de forma oportuna y el manejo multidisciplinario son fundamentales para determinar un buen pronóstico en estos pacientes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Bee stings produce the greatest number of accidents in many countries. Unusual systemic manifestations have been described after exposure to Hymenoptera venom. Less frequently, neurological complications, myocardial infarction, rhabdomyolysis and renal failure have been documented. This type of systemic allergic reactions occur in 0.3-7.5% of the population.  Case report:  A 39-year- old male, logger, from the rural área of Comayagua, Honduras, had a history of suffering multiple bee stings (Apis mellifera) with a syncopal episode, trauma in parietal-forehead bilateral region and 3 hours of evolution. He was treated at a health service in Comayagua and transferred to the University School Hospital, where treatment was continued due to severe anaphylaxis and extraction of multiple stings. Later he began with stridor, cianosis and dyspnea, so endotracheal intubation was performed. Physical examination revealed significant facial edema, multiple lesions and excoriations, irregular respiratory pattern, generalized stings, and the presence of hypoventilation in both lung fields. Glasgow 13/15, generalized hyperalgesia. Laboratory tests showed leukemoid reaction, severe neutrophilia, hyperhemoglobinemia, increased nitrogen levels, elevated liver enzymes, hypoalbuminemia, hydroelectrolytic disorders and mixed acidosis. He later progressed to multiorgan failure and rhabdomyolysis (hemodynamics, ventilatory, renal), and died 48 hours after admission.  Conclusion: The number of bites and the amount of poison inoculated are predictive factors of high mortality and low survival. The transfer in a timely manner and multidisciplinary management are essential to determine a good prognosis in these patients.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Apis mellifera]]></kwd>
<kwd lng="es"><![CDATA[himenóptera]]></kwd>
<kwd lng="es"><![CDATA[veneno de abeja]]></kwd>
<kwd lng="es"><![CDATA[anafilaxia]]></kwd>
<kwd lng="es"><![CDATA[rabdomiólisis]]></kwd>
<kwd lng="en"><![CDATA[Apis Mellifera]]></kwd>
<kwd lng="en"><![CDATA[honeybee]]></kwd>
<kwd lng="en"><![CDATA[Hymenoptera]]></kwd>
<kwd lng="en"><![CDATA[bee venoms]]></kwd>
<kwd lng="en"><![CDATA[anaphylaxis]]></kwd>
<kwd lng="en"><![CDATA[rhabdomyolysis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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