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Human Sting of Cephalonomia gallicola (Hymenoptera: Bethylidae) in Korea

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Hymenoptera stings can cause serious injury to humans. We report the clinical findings of 6 cases of Hymenoptera stings. All patients developed painful erythematous papules at the sting sites and had a past history of parasitoid wasp sting. This is the first clinical report of the parasitoid wasp, Cephalonomia gallicola, causing human stings in Korea.
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681
INTRODUCTION
Hymenoptera are one of the medically most important in-
sects. The stings of Hymenoptera, including Apoidea (bees),
Vespoidea (wasps, hornets, and yellow jackets), and Formici-
dae (poneromorph ants), account for the majority of severe
allergic reactions to insects [1]. Many of the Hymenoptera are
parasitoids. The Bethylidae is a family of Hymenoptera that
consist of approximately 82 genera and 2,200 species world-
wide have evolved to exploit coleopteran and lepidopteran
larvae and pupae, and are often found in cryptic locales such
as soil, leaf litter, wood, stems, and seeds.
Cephalonomia gallicola (Bethylidae) is a gregarious external
parasitoid of the larvae and pupae of the cigarette beetle, Lasio-
derma serricorne (Coleoptera: Anobiidae), which is an injurious
pest to stored dried products, other animals and vegetable ma-
terials [2]. The Bethylidae is one of the most powerful epizoic
parasitoid wasps and contains anesthetic compounds, which
cause painful irritation at the site of the sting. Human stings
by Bethylidae, a parasitic wasp, have been reported in Europe
and North America [3], Japan [4], and New Zealand [5]. In
such cases, Cephalonomia, Goniozus, and Sclerodermus species
were involved. Those species should be considered as a cause
of allergic responses in patients living in houses with visual ev-
idence of parasitoid wasp infestation. To date, there have been
no clinical reported investigations on parasitoid wasp stings in
Korea. We describe here the clinical findings of 6 cases of C.
gallicola sting detected in 2013.
CASE RECORD
The patients (Table 1) visited the Arthropods of Medical Im-
portance Resource Bank, and were referred to Yonsei Universi-
ty Severance Hospital (Seoul, Korea) because of multiple in-
sect sting markings.
Case 1 was a 39-year-old female with severe pain at the sting
sites and had erythematous papules over her hand (Fig. 1). She
had no significant abnormalities of the cardiovascular, respira-
tory, nervous, or gastrointestinal systems. She observed insects
in the bedroom of her home and suspected that they were the
cause of her complaints. She brought in an insect that had been
caught in her bedroom. On examination, the insect was identi-
fied to be a female C. gallicola (Figs. 2, 3). Casts of C. gallicola
were found in the food storage room of her home (Fig. 4).
Case 2 was a 35-year-old male with generalized sting marks
over his right arm. He was treated with oral antibiotics, oral
antihistamines, and topical corticosteroid cream by a physi-
cian at private clinic, resulting in an improvement of local
symptoms. He did not have any significant problems immedi-
ately after being stung, except for local swelling and itching at
the sting sites. He also brought in an insect that had been
caught in the living room of his home. On examination, the
ISSN (Print) 0023-4001
ISSN (Online) 1738-0006
Korean J Parasitol Vol. 52, No. 6: 681-684, December 2014
http://dx.doi.org/
10.3347/kjp.2014.52.6.681
CASE REPORT
Received 6 March 2014, revised 20 August 2014, accepted 31 August 2014.
*
Corresponding author (tsyong212@yuhs.ac)
© 2014, Korean Society for Parasitology and Tropical Medicine
This is an Open Access article distributed under the terms of the Creative Commons
Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0)
which permits unrestricted non-commercial use, distribution, and reproduction in any
medium, provided the original work is properly cited.
Human Sting of Cephalonomia gallicola (Hymenoptera:
Bethylidae) in Korea
In-Yong Lee
1
, Chang-Seob Shin
2
, Seobo Sim
3
, Jung-Won Park
4
, Tai-Soon Yong
1,
*
1
Department of Environmental Medical Biology and Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea;
2
Gangnam Clean Pest Control, Seoul 135-862, Korea;
3
Department of Environmental and Tropical Medicine, School of Medicine, Konkuk University,
Chungju 380-701, Korea;
4
Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
Abstract:
Hymenoptera stings can cause serious injury to humans. We report the clinical findings of 6 cases of Hyme-
noptera stings. All patients developed painful erythematous papules at the sting sites and had a past history of parasitoid
wasp sting. This is the first clinical report of the parasitoid wasp, Cephalonomia gallicola, causing human stings in Korea.
Key words:
Cephalonomia gallicola, human sting, Hymenoptera, parasitoid wasp, Korea
682
Korean J Parasitol
Vol. 52, No. 6: 681-684, December 2014
insect was identified to be a female C. gallicola.
Case 3 was a 42-year-old female with severe pain at the sting
sites and erythematous papules over her abdomen. She had
no significant abnormalities in any other organ. She brought
in an insect that had been caught in the bedroom of her
home. On examination, the insect was also identified to be a
female C. gallicola.
Case 4 was a 31-year-old female with severe pain at the sting
sites and erythematous papules over her left leg. She also
brought an insect that had been caught in her bedroom. On ex-
amination, the insect was identified to be a female C. gallicola.
Case 5 was a 51-year-old male with swelling and itching at
Table 1. Summary of the clinical finding of 6 cases of Cephalonomia gallicola sting in 2013
Patient
no.
Time of
observation
Sex
Age
(year)
Location
No. of
lesions
Residence House type
Sites
of sting
Collection
of wasps
1 May 10 F 39 hand 7 Sanggye, Seoul apartment bedroom 3
2 May 27 M 35 arm 4 Galmal, Gangwon private living room 2
3 June 13 F 42 abdomen 3 Gahoe, Seoul private living room 1
4 June 29 M 31 leg 3 Seongnam, Gyeonggi apartment living room 5
5 July 6 M 51 abdomen 5 Yeonhui, Seoul apartment bedroom 2
6 August 3 M 3 arm/leg 3 Ansan, Gyeonggi private bedroom 3
Fig. 1. Erythematous papules with central punctums on the hand
of a patient, caused by Cephalonomia gallicola.
Fig. 3. Apical abdominal segment with a needle-like stinger ( ×
400).
Fig. 2. A female of Cephalonomia gallicola, whole body. Scale
bar = 0.5 mm.
Fig. 4. Cast of Cephalonomia gallicola.
Lee et al.: Human sting of Cephalonomia gallicola in Korea 683
the sting sites and generalized sting marks over his abdomen.
He also brought in insects from his bedroom. On examination,
the insects were identified to be female C. gallicola. His lesions
disappeared 1 week after the discovery of the insects without
medical treatment of antihistamines or corticosteroids.
Case 6 was a 3-year-old male with signs of redness, swelling,
and pain at the sting sites. His father suspected the presence of
insects in the boy
s bedroom. Three captured specimens were
submitted to us for identification and were all found to be fe-
male C. gallicola. He was treated with topical corticosteroid
cream resulting in the subsidence of local symptoms.
Measurements of 16 C. gallicola females were obtained from
observing the specimens with a microscope equipped with a
micrometer. C. gallicola while monomorphic, do vary slightly
in length and are approximately 1.98 mm to 2.59 mm long
(average 2.23 mm) (Table 1). Body usually rounded and brown
entirely. Antennae well developed and 12 segmented. Thorax
with pronotum bell-shaped. Abdominal segments well devel-
oped and postabdomen with a diminutive sting (Figs. 2, 3).
Antihistamines and/or corticosteroids were given to all pa-
tients and the signs and symptoms in all patients improved
within 2 weeks. Disinfestation of the patients
houses was per-
formed using treatment with commercial insecticide (0.5%
permethrin) in all rooms of the house, keeping it sealed. Three
days after the insecticide treatment, an investigation was per-
formed to confirm the elimination of insects from the house,
and no parasitoid wasp, C. gallicola, has been found to date.
DISCUSSION
Hymenoptera sting is a major clinical problem. Hymenop-
tera venoms contain many pharmacologically active constitu-
ents, including histamine, serotonin, acetylcholine, dopamine,
noradrenaline, melittin hyaluronidase, apamin, and phospho-
lipase [1]. The typical human sting reactions include headache,
giddiness, nausea, pain at the sting sites, shortness of breath,
and anaphylactic responses.
The parasitoid wasp, C. gallicola, has a diminutive stinger
and stings if it is irritated. Stings from C. gallicola causes medi-
cal problem. In our case, C. gallicola sting was associated with
indoor activities. Probably, the females were searching for lar-
val forms of Coleoptera in household. The stings were inflicted
on the hands, arms, legs, and abdomen. In case of skin lesions,
exhibited redness, swelling, and pain at the sting sites, with the
development of pruritic erythematous papules, similar to oth-
er arthropod bites and stings. C. gallicola wasp most frequently
sting humans during the spring (May) and summer (June-Au-
gust), though the pattern depends on parasitoid wasp activity
in nature.
The parasitoid wasp fauna of Korea, C. gallicola [2], Scleroder-
mus harmandi [6], and 5 species of Goniozus, including G. kore-
anus, G. mesolevis, G. akitsushimanus, G. yoshikawai, and G. mau-
rus [7], have been documented. Goniozus and S. harmandi are
found mainly in the outdoor environment, while C. gallicola is
found indoors. C. gallicola coexist with Pachycondyla chinensis
in the indoor environment in Korea. C. gallicola are very simi-
lar to P. chinensis morphologically and the 2 are very difficult
to distinguish. C. gallicola is a wasp and P. chinensis is an ant. P.
chinensis was reported to be the only ant sting in the home en-
vironment. These stinging ants included a total of 12 species
in 6 genera of the poneromorph group in Korea [8]. Anaphy-
lactic reactions were occasionally induced by P. chinensis [9-11].
An ant sting can cause a wide range of allergic responses in
sensitized individuals. The sensitization rate to P. chinensis was
found to be 23.0% in residents living in an endemic area, and
2.1% of the residents were reported to have a history of sys-
temic allergic reactions to the ant in Korea [11].
The characteristic morphology of the skin lesion and history
are very important in making the diagnosis of Hymenoptera
sting. Skin lesions can be similar to various types of dermatitis
and other skin pathologies. Diagnosis should be based on the
history and physical findings of Hymenoptera sting. The skin
lesions caused by C. gallicola, an etiologic diagnosis may be
difficult. Confirming the diagnosis of a C. gallicola, sting is
sometimes difficult to be suspected unless to obtain a detailed
explanation of the home environment.
The clinical diagnosis of C. gallicola sting should take into
accounts the many potential reactions to the insect
s bite/sting.
Further investigations are necessary to examine the possibility
of cross sensitization between allergic disorders caused by C.
gallicola and P. chinensis.
To the best of our knowledge, this is the first clinical find-
ings report of human stings by the parasitoid wasp, C. gallicola,
in Korea.
ACKNOWLEDGMENTS
This study was supported in part by the National Research
Foundation of Korea (NRF-2012M3A9B8021806). We thank
Prof. Seunghwan Lee, Division of Entomology, Seoul National
684
Korean J Parasitol
Vol. 52, No. 6: 681-684, December 2014
University, Korea for his kind assistance in the identification of
specimens.
CONFLICT OF INTEREST
We have no conflict of interest related to this study.
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... Dins aquest gènere, s'ha enregistrat parasitisme cap a coleòpters de les families Anobiidae, Bostrychidae, Buprestidae, Ciidae, Cucujidae, Tenebrionidae, Curculionidae i Silvanidae (Azevedo et al., 2018). La picada d'insectes d'aquesta família pot produir una irritació dolorosa, amb possibles complicacions relacionades amb respostes al·lèrgiques (Lee et al., 2014). D'acord amb Azevedo et al. (2018), els Bethylidae trobats a Sóller pertanyen al gènere Cephalonomia (Fig. 1A) ja que són àpters (tot i que hi ha espècies dins aquest gènere que tenen ales), tenen les antenes amb 10 flagelòmers (Fig. 1B), les mandíbules tridentades (Fig. 1D) i són de color groc-marronós. ...
... La picada d'un fibló (Fig. 1C) de Bethylidae sol produir pàpules eritematoses (Hatsushika et al., 1990;Fuentes et al., 2009;Lee et al., 2014), amb irritació dolorosa, generant mal i molèsties que poden durar des d'uns dies a una setmana (Fuentes et al., 2009;Lee et al., 2014). Els efectes d'una picada d'aquest estil poden variar en funció de la zona del cos i la reacció que cada persona pugui arribar a tenir als components del verí d'aquestes vespes. ...
... La picada d'un fibló (Fig. 1C) de Bethylidae sol produir pàpules eritematoses (Hatsushika et al., 1990;Fuentes et al., 2009;Lee et al., 2014), amb irritació dolorosa, generant mal i molèsties que poden durar des d'uns dies a una setmana (Fuentes et al., 2009;Lee et al., 2014). Els efectes d'una picada d'aquest estil poden variar en funció de la zona del cos i la reacció que cada persona pugui arribar a tenir als components del verí d'aquestes vespes. ...
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Five species of Goniozus are recognized in Korea. Goniozus koreanus Lim, sp. nov. and G. mesolevis Lim, sp. nov. are described and figured; G. akitsushimanus Terayama, 2006 and G. yoshikawai Terayama, 2006 are newly recorded from Korea. Goniozus maurus Marshall, 1905 is excluded from Korean fauna. A key to the Korean species in females is provided.
Article
This study was performed to investigate the immature development period, fecundity, emergence rate and sex ratio of Sclerodermus harmandi against different host insects, Monochamus alternatus, M. saltuarius and Psacothea hilaris. Full grown larvae and pupae of host insects were provided with foods. The mean larval period of S. harmandi female was 29.2?0.93\;and\;25.1?0.47 days in larvae and pupae of M. alternatus, 27.1?0.41\;and\;26.0?0.69 days in M. saltuarius, and 26.3?0.38\;and\;31.2?0.24 days in P. hilaris, respectively. S. hilaris adults were emerged at 12.9?0.2 days in female and 11.9?0.2 days in male after pupation when hosted M. alternatus pupa. Development period in male showed shorter one day than in female. Success rate of oviposition against different hosts was higher as 98.6 and 97.5% on full grown larva and pupa of M saltuarius. Emergence rate was higher as 90.1 and 87.3% on M. saltuarius larvae and pupae. Sex ratio of emerged S. harmandi adults was approximately 10:1 (Female : Male), females showed higher emergence rate than males. The period until first oviposition after emergence in S. harmandi female was the shortest in 4.6?0.1 days on M. saltuarius pupa. When three females of S. harmandi were inoculated on M. saltuarius larva, the number of laid eggs was the highest 62.7?2.5 per female.
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The effects on a human of the sting of Goniozus antipodum Westwood (Bethylidae) are recorded.
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An ectoparasitoid natural enemy, Cephalonomia gallicola (Ashmead 1887) (Hymenoptera: Bethylidae) was found in the mass rearing colonies of cigarette beetle, Lasioderma serricorne (Fabricius 1792) (Coleoptera: Anobiidae), under laboratory condition. As the first record in Korea, the description of the apterous female is provided for the macerated microslide specimens, with the detail illustration for the taxonomic characteristics and the biometric data. © 2007 Korean Society of Applied Entomology, Taiwan Entomological Society and Malaysian Plant Protection Society.
Article
In the southeastern United States, imported fire ants have caused systemic reactions with a high incidence. On the contrary, in Korea Pachycondyla species ants (P chinensis and P solitaria), and the family Formicidae, which are in the genus Pachycondyla and the subfamily Ponerinae, have only occasionally caused systemic reactions. We sought to assess whether commercially available imported fire ant extract would be useful in treating patients with anaphylaxis induced by venom from a Pachycondyla species ant. Serum samples were collected from 2 women who had anaphylaxis induced by Pachycondyla species ant venom and from 6 volunteers with no history of having been stung. Specific IgE to Pachycondyla species ant extracts was measured by means of ELISA and possible allergenic components by immunoblot. Cross-reactivity between Pachycondyla chinensis, P solitaria, and imported fire ant extracts was also measured by inhibitory ELISA. Skin prick test responses were strongly positive to the extract of P chinensis (1:20 wt/vol) in the patient. Ten healthy volunteers exhibited negative responses. The 2 patients' sera exhibited high ELISA values, with absorbencies of 0.78 and 0.61 for P chinensis and 0.83 and 0.68 for P solitaria, respectively, and negative ELISA values for the extract of imported fire ants (absorbency <0.01). Imported fire ants showed no inhibition of the IgE binding to P chinensis or P solitaria. Possible allergenic components of Pachycondyla species ant extracts are 29- and 27-kd proteins and, less frequently, 16 kd proteins. Our data suggest that patients who have had an anaphylactic reaction to a Pachycondyla species ant might not benefit from immunotherapy with an imported fire ant extract. Immunotherapy with the extract of Pachycondyla species ants is expected to be highly effective.
Article
There have been no reports dealing with the pathogenic mechanism and IgE-binding components in patients with anaphylaxis caused by a sting from Pachycondyla chinensis. This study was conducted to observe the clinical features of patients with P chinensis -induced anaphylaxis. The roles of specific (s) IgE and sIgG4 antibodies were evaluated, and IgE-binding components were identified. Seven patients with P chinensis -induced anaphylaxis and 15 unexposed control subjects were enrolled. P chinensis ants were collected at the patients' homes, and venom was prepared as P chinensis extract. Five patients complained of bee venom-induced anaphylaxis and had positive sIgE levels to yellow jacket venom, wasp venom, or both as well. Serum sIgE and sIgG4 were detected by means of ELISA. To identify IgE-binding components within P chinensis extracts, 12% SDS-PAGE with immunoblot analysis was applied. All patients had positive skin prick test responses to P chinensis antigen and positive sIgE levels. Five (71%) patients had positive sIgG4 levels. Eight IgE-binding components (58, 46, 3l, 29, 27, 25, 22, and 12 kd) were noted, and the component at 12 kd was the most frequently found allergen (85%). IgE ELISA inhibition tests were performed on 2 groups of sera: one from patients with anaphylaxis induced by both P chinensis and bee venom (group A) and the other from patients with anaphylaxis induced by P chinensis venom alone without bee venom allergy (group B). ELISA inhibition tests with serum from group A showed significant inhibitions with addition of P chinensis extract, partial inhibitions with yellow jacket antigen, and minimal inhibitions with wasp or imported fire ant antigens. However, ELISA inhibition tests with serum from group B showed significant inhibitions with P chinensis antigen but no inhibition with wasp, yellow jacket, or imported fire ant antigens. IgE-mediated reactions contributed to the development of P chinensis -induced anaphylaxis. Eight IgE-binding components and one major allergen (12 kd) were identified. Further studies will be needed to clarify the role of sIgG4 and to identify allergenic relationships with major bee and wasp allergens.