Abstract
A urinary tract infection (UTI) is an infection in any part of the urinary system. The urinary system includes the kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra. This article contains 1. how bee venom is affecting the urinary system 2. Antimicrobial activity of apis mellifica 3. Acute case of urinary tract infection cured with apis mellifica.
Bee Venom (Apis Mellifica) Components And Its Effects On Urinary System
Bee venom is a complex mixture of proteins, peptides and low molecular-weight components with a higher percentage of proteins and peptides. Among the proteins, phospholipase a2 and hyaluronidase enzymes are the main ones. Melitin is the main peptide and is the main component of bee venom, and apamin is also present, as well as phospholipids, some histamine and myoglobin, epinephrine, norepinephrine, aminobutyric acid, alpha-amino acids, glucose, fructose, complex ethers, phosphorus, calcium, and magnesium
Africanized bees are usually identified as insects responsible for nephrotoxic acute tubular necrosis, as they attack in clusters. Acute kidney injury can be observed in patients suffering from bee stings and this is due to multiple factors, such as intravascular hemolysis, rhabdomyolysis, hypotension, and direct toxicity of the venom components to the renal tubules. Arterial hypotension plays an important role in this type of AKI, leading to ischemic renal lesion
Bee venom, which has as its main components hyaluronidase, phospholipase a2, melitin and apamin, contributes to renal damage due to synergistic toxic and hypotensive effects. Moreover, these substances can induce the release of several other mediators, such as histamine, serotonin, bradykinin and prostaglandin. These substances are vasoactive and may lead to a reduction in systemic blood pressure. A reduction in the norepinephrine content was observed in rats inoculated with bee venom, suggesting a great release of this mediator. In cardiac tissue, this can cause ischemic lesions and acute myocardial infarction, reducing the cardiac output and, consequently, leading to a reduction in renal blood flow. Due to renal hypoperfusion, the renin-angiotensin-aldosterone system activation and increase in the adrenergic neural stimulus occurs, with catecholamine secretion. All these factors induce vasoconstriction of afferent and efferent arterioles, with reduced glomerular and peritubular blood flow, leading to ischemia and the development of acute tubular necrosis. The most commonly identified biopsy finding in these cases is acute tubular necrosis, which can occur both due to ischemic injury and nephrotoxicity of venom components
Sodium and potassium excretion fractions were increased suggesting the involvement of proximal nephron portions and distal tubule preservation. The above-mentioned studies suggest that the venom of africanized bees is freely filtered by the renal glomeruli and is reabsorbed mainly by the proximal tubules.
Clinical Manifestation And Laboratory Abnormality
A common complication in bee sting accidents is acute kidney injury (AKI). The onset of the first manifestations of this complication occurs 24 to 48 hours after the accident, and it is due to the great amount of inoculated poison. Other manifestations that may occur are oligo-anuria, macroscopic hematuria and other changes in the urine analysis. Other signs and symptoms resulting from the toxic effects of bee venom are nausea, vomiting, hyperventilation (acid breathing), generalized edema, myalgia, arthralgia, headache, restlessness and consciousness alteration.
Changes in the urine analysis include reduction in urinary density, proteinuria, hemoglobinuria, hematuria, leukocyturia and hemoglobin or myoglobin pigment cylinders.
Antimicrobial Properties of Apis Mellifica
Bees are insects found on all continents, many of these species have yet to be described and are an exciting source for the study and search for new molecules with antimicrobial properties. There are experimental and clinical reports on Apis mellifeca venom and its anti-inflammatory, antimicrobial, and anticancer effects; the components present in the venom, such as proteins, vary from a summer season compared to a winter season, in addition, have shown different therapeutic properties against oxidative stress induced by beta-amyloid . For parkinson’s disease, the neuroprotective potential of bee venom against oxidative stress induced by rotenone (pesticide) has been demonstrated in a mouse model, including preventing the decrease in dopamine and also restoring locomotor activity in mice. For lyme disease, the melittin present in the venom showed in vitro antibacterial effects against the causative agent borrelia burgdorferi and even had significant antibacterial effects against e. Coli, s. Aureus, and salmonella typhyimurium. Melittin also exhibited antibacterial activity against MRSA strains, with antimicrobial potential against agents that cause dental caries, with antifungal capacity including suppression of biofilm formation. Its significant antiviral potential has also been demonstrated in in vitro and in vivo assays on different enveloped (influenza a) and non-enveloped (enterovirus-71) viruses. In addition, phospholipase a2 (pla2) can also block the replication of the virus, being shown to be responsible for the inhibition of hiv replication. The present study aimed to evaluate the in vitro antibacterial activity of apis mellifera venom collected in the beekeeping areas of the city of Lambayeque in northern Peru against escherichia coli, pseudomonas aeruginosa, and staphylococcus aureus.
Urinary Tract Infection
UTI may be asymptomatic (subclinical infection) or symptomatic (disease). Thus, the term urinary tract infection encompasses a variety of clinical entities, including asymptomatic bacteriuria (asb), cystitis, prostatitis, and pyelonephritis.
Micro Organism Involved In Urinary Tract Infection
The uro pathogens causing uti vary by clinical syndrome but are usually enteric gram-negative rods that have migrated to the urinary tract. The susceptibility patterns of these organisms vary by clinical syndrome and by geography. In acute uncomplicated cystitis in the United states, the etiologic agents are highly predictable: e. Coli accounts for 75–90% of isolates; staphylococcus Saprophyticus for 5–15% (with particularly frequent isolation from younger women); and klebsiella, proteus, enterococcus, and citrobacter species, along with other organisms, for 5–10%. Similar etiologic agents are found in Canada, South America, and europe. The spectrum of agents causing uncomplicated pyelonephritis is similar, with e. Coli predominating. In complicated uti (e.g., cauti), e. Coli remains the predominant organism, but other aerobic gram-negative rods, such as pseudomonas aeruginosa and klebsiella, proteus, Citrobacter, acinetobacter, and morganella species, also are frequently isolated. Gram-positive bacteria (e.g., enterococci and staphylococcus aureus) and yeasts also are important pathogens in complicated uti. Data on etiology and resistance are generally obtained from laboratory surveys and should be understood in the context that organisms are identified only in cases in which urine is sent for culture—typically, when complicated uti or pyelonephritis is suspected.
Clinical Features
1. Asymptomatic Bacteriuria
A diagnosis of asb can be considered only when the patient does not have local or systemic symptoms referable to the urinary tract. The clinical presentation is usually bacteriuria detected incidentally when a patient undergoes a screening urine culture for a reason unrelated to the genitourinary tract.
2. Cystitis
The typical symptoms of cystitis are dysuria, urinary frequency, and urgency. Nocturia, hesitancy, suprapubic discomfort, and gross hematuria are often noted as well. Unilateral back or flank pain suggests that the upper urinary tract is involved, and is thus inconsistent with uncomplicated cystitis. Fever likewise suggests invasive infection beyond the bladder, involving kidney, prostate, or bloodstream.
3. Pyelonephritis
Mild pyelonephritis can present as low-grade fever with or without lower-back or costovertebral-angle pain, whereas severe pyelonephritis can manifest as high fever, rigors, nausea, vomiting, and flank and/or loin pain. Symptoms are generally acute in onset, and symptoms of cystitis may not be present. Fever is the main feature distinguishing cystitis from pyelonephritis. The fever of pyelonephritis typically exhibits a high spiking “picket-fence” pattern and resolves over 72 h of therapy.
Case Of Urinary Tract Infection
A 60 year male patient has been complaining of fever with chills since one day with no periodicity or any other modality with generalized weakness and fatigue. Patient is having complain of mild pain at hypogastric region and complain of burning before and after urination since one day. He has no history of travelling or any bad hygiene exposure.
Vital Parameter
1. Blood Pressure – 142/86 mm/hg
2. Pulse – 96/min
3. Respiratory rate – 18/min
4. SpO2 – 99%
5. No pallor, no anemia, no clubbing, no edema, no lymphadenopathy
6. No xanthoma or lipid deposition around knuckles
7. Respiratory system – B/L airway entry clear
8. Cardiovascular system – HS1 HS2 heard clear
9. Abdomen – per abdomen soft and mild tenderness at hypogastric region
10. Central nervous system – no abnormal neurological sign.
11. Built – well built (weight-74 kg)
12. Temperature – 100 ℉
Past History
1. Typhoid fever – in 2018 (allopathic treatment for 5 days)
Family history
1. Father – died – ischemic heart disease
2. Mother – died – no major illness
Physical General
Appetite – 3 meal/day
Thirst – thirstless since 4 – 5 days (2 – 3 glass of water)
Stool – normal bowel habit
Urine – yellow with burning before and after urination
Sleep – disturb since one day due to illness
Perspiration – only on exertion, non offensive, no staining
Dreams – no significant dreams
Desire – not specific
Aversion – not specific
Blood test on 29/5/2024 – complete blood count and urine routine micro shows
WBC – 17100/cumm
Neutrophils – 75
Occult blood – present++
Red blood cell – 8 – 10
Pus cell – 12 – 14
Epithelial cell – 4 – 5
Cast – pus cast+
Analysis
As the patient is thirstless and having symptoms of urinary tract infection apis is given as final remedy
Remedy – Apis Meliifica 200 od for 7 days
Sl tds for 7 days
Advice – Drink plenty of water and lemon water to maintain hygiene and hydration. After 7 days of advice for a blood test and urine test.
After 7 days on 6/5/24
On 6/5/24 – patient having no spike of fever or chill, his appetite and thirst get normal, no features of burning micturition and weakness. All investigation gets normal.
Patients become asymptomatic and stop treatment.
Conclusion
Apis mellifica has antimicrobial properties and has marked action on the urinary tract. Homoeopathy has scope in urinary tract infection and cure the disease without any kind of antibiotics and allopathic medication.
Reference
- Harrison’s principles of internal medicine 21 edition.
- Phatak materia medica
- Https://www.ncbi.nlm.nih.gov/pmc/articles/pmc10135115/
- Https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5459532/
- https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
