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Skin is the largest organ in the human body, it is a protective barrier that guarding the body against high temperature, ultra violent light , and harmful chemicals. It produces antibacterial substances that prevent infection like boils.
Boils are a common nuisance that spoils the comfort of many people from around the world. Characterized by redness, pain, and the formation of pus in the center which tends to "point" and drain through the skin (Edwards, 1993). Boils present as one or more tender red spots, lumps or pustules. It is a deep form of bacterialÂ folliculitis ; superficial folliculitis is sometimes present at the same time. (dermnetnz.org)Â Boils has different types, among those are FuruncleÂ or carbuncle that can have one or more openings onto the skin and may be associated with aÂ fever or chills. It is an abscess that involves a group of hair follicles. Another type is CysticÂ acne this is a type of abscess that is created when oil ducts become blocked and infected, this affects deeper skin tissue than the more superficial inflammation from common acne. Most common on the face and typically occurs in the teenage years. The formation of multiple abscesses under the armpits and often in the groin area are called Hidradenitis suppurativa as a result of local inflammation of the sweat glands. Pilonidal cyst is a unique kind of abscess that occurs in the line of the buttocks. PilonidalÂ cystsÂ often begin as tiny areas of infection in the base of the area of skin from which hair grows . (medicinenet.com)
Boils are caused by Staphylococcus aureus, they are gram-positive cocci, in pairs, and in irregular, grapelike clusters, nonmotile, non-spore-forming, and catalase-positive bacteria, facultative anaerobes that grow by aerobic respiration or by fermentation.The termÂ StaphylococcusÂ is derived from the Greek termÂ staphyle,Â meaning "a bunch of grapes." The cell wall contains peptidoglycan and teichoic acid. The organisms are resistant to temperatures, high salt concentrations, and to drying. Colonies are usually large (6-8 mm in diameter), smooth, and translucent. The colonies are pigmented, cream-yellow to orange. (emedicine.medscape.com)
Staphylococcus aureus which belong to the Bacterial family Staphylococcaceae are normal inhabitants of the human skin surface and cause boils when they manage to enter openings in the epidermis such as sweat pores and hair follicles or when there is a localized infection that causes pus and infected material to collect in the skin or subcutaneous tissue. (skin-care.health-cares.net) The bacteria multiply, and the immune response of the body brings about an inflammation. Skin abscesses are painful, and may disrupt the everyday living of an individual in most cases, depending on the severity and location of the abscess.
There is a claim from a source that after being stung by wasps while climbing a tree, his skin abscess healed faster than usual. The inflammation subsided the next day. It is by this claim that this research was based. By studying the effects of wasp venom in localized Staphylococcus aureus skin infections, the solution to the problem of boils might come to light. Related to this, there are people who use bee therapy, also called Apitherapy which has therapeutic use for arthritis, gout ,Lupus, Lyme disease, neuropathy, cancerous tumors etc. wherein they sting themselves with killer bees in which the poison is said to have a therapeutic effect on the body. The healing potency of bee venom is initiated after sting, when it stimulates the adrenal glands to produce cortisol, a natural human hormone that has anti-inflammatory properties. (beewelltherapy.com)
STATEMENT OF THE PROBLEM
This study will test the effects of wasp venom on skin infections caused by Staphylococcus aureus.
Specifically, this study aims to do the following:
What is the effect of wasp venom on the diameter of the lesion?
What are the changes on the signs of inflammation after wasp venom is induced?
Is there a deviation from the usual or normal course of the skin infection after the application of wasp venom?
The wasp venom has no significant effect on Staphylococcus aureus skin infections.
The time of healing of Staphylococcus aureus skin infections is not affected by introduction of wasp venom to the system.
SIGNIFICANCE OF THE STUDY
The results of this study will determine the effects of wasp venom on Staphylococcus aureus skin infections. This research might lead to confirming the claim that wasp venom has the ability to lessen the extent of inflammation or even completely heal the infection. Thus, wasp venom could be a potential remedy for staphylococcal skin infections, such as furuncles, carbuncles, folliculitis and impetigo.
SCOPE AND DELIMITATION
The scope of this study is for the observation of Staphylococcus aureus skin infections after envenoming with wasp poison. This research will collect data on the diameter of the skin lesion, the effects on inflammation, and the time of healing.
Review of Related Literature and Studies
A study made by AtanaskovaN,TomeckiKJ (2010) entitled "Innovative management of recurrent furunculosis" stated that one of the most general bacterial infections of the skin and soft tissue is furunculosis (boil), an inflammatory swelling that involves the hair follicle, with small abscess formation extending through the dermis into the subcutaneous layers. The mainstay of therapy is incision and drainage of a furuncle coupled with bacterial culture. Affected patients and their family members must practice good hygiene, predicated with regular hand washing, fomite cleaning, and avoiding contact with contaminated skin.
According to a research done by Aust W,Â Wichmann G,Â Dietz AÂ (2010) entitled "Therapy control of specific hymenoptera venom allergy" mentioned that in Germany anaphylactic reactions after insect stings are mostly caused by honey bee (Apis mellifera) and wasp (Vespula vulgaris, Vespula germanica). Majority of cases, venom immunotherapy is a successful therapy and protects patients from repeated systemic anaphylactic reaction. In some patients constant severe reactions after insect sting can even occur in spite of venom therapy, as a sign of therapy failure. It is important to identify these patients, who do not benefit from venom immunotherapy, in an early stage of therapy. In this case dose rate of venom immunotherapy must be adjusted for a successful therapy outcome. Skin prick tests and in vitro diagnostics are not suitable for detecting therapy failure. Patients with treatment failure can be diagnosed by insect sting test and almost all of them will become fully protected by increasing the maintenance dose.
The study "Desensitization of allergy to hymenoptera venoms" made by Przybilla B,Â Ruëff F (1999) discusses that hyposensitization (immunotherapy) of hymenoptera venom allergy has been accomplished for 70 years. About 20 years ago the use of ineffective whole-body extracts was abandoned, as effective therapy with preparations of bee venom and wasp venom became available. Immunotherapy is indicated in all patients with systemic IgE-mediated immediate type reactions, only in children with exclusive skin symptoms it may not be needed. Allergen preparations for subcutaneous injection are available as aqueous preparations or as aluminium hydroxide-adsorbed depot extracts. Various rush or conventional treatment protocols are used to reach the maintenance dose of usually 100 micrograms venom/four weeks. The most frequent side effects are large local reactions, which are observed in almost all patients. Systemic anaphylactic side effects also occur in up to 40%, in most cases the symptoms are mild. To identify patients who are not protected by the usual maintenance dose, a sting challenge test with a living insect should be performed. By this, about 80 to 100% of the patients are found to be protected from systemic symptoms, and in those still reacting an increased dose of 200 micrograms (or even higher) eventually induces protection. Hyposensitization may be stopped if it lasted at least for 3 to 5 years, if systemic side-effects did not occur and if the patient has tolerated a sting challenge or a field-sting without systemic symptoms.
"Hymenoptera venom allergy" is a study made by Pryzbilla B, Ryeff F. (2010) discusses that allergic reactions to Hymenoptera stings usually shows large local reactions or systemic reactions with symptoms of immediate type allergy (anaphylaxis). In Central Europe they are predominantly elicited by stings of the honeybee or Vespula spp. Acute reactions are managed by symptomatic treatment. Long-term care includes patient education (allergen avoidance, course of action at re-sting) and prescription of an emergency kit for self-treatment. Venom immunotherapy is established as specific treatment for Hymenoptera venom allergic patients. Diagnosis of Hymenoptera venom anaphylaxis is based on history, skin tests and measurement of venom-specific serum IgE antibodies. "False negative" or "false positive" results are possible with all test methods. If standard tests are negative, additional tests using the patient's peripheral blood leucocytes can be useful. If the patient again develops a systemic reaction, an increase of the maintenance dose (usually 200 microg are sufficient) nearly always induces protection. In most patients venom immunotherapy can be stopped after (3 to) 5 years. However, if there is an increased risk of sting anaphylaxis due to intense allergen exposure or if there are individual risk factors for particularly severe reactions modifications of the standard venom immunotherapy are necessary.
Another research completed by Bilo BM,Â Rueff F,Â Mosbech H,Â Bonifazi F,Â Oude-Elberink JN(2005) is the "Diagnosis of Hymenoptera venom allergy" which stated that the purpose of diagnostic procedure is to classify a sting reaction by history, identify the underlying pathogenetic mechanism, and identify the offending insect. Diagnosis of Hymenoptera venom allergy as a result forms the basis for the treatment. In the central and northern Europe vespid (mainly Vespula spp.) and honeybee stings are the most prevalent, whereas in the Mediterranean area stings from Polistes and Vespula are more frequent than honeybee stings. Several major allergens, usually glycoproteins with a molecular weight of 10-50 kDa, have been identified in venoms of bees, vespids. and ants. The sequences and structures of the majority of venom allergens have been determined and several have been expressed in recombinant form. Venom hypersensitivity may be mediated by immunologic mechanisms (IgE-mediated or non-IgE-mediated venom allergy) but also by nonimmunologic mechanisms. Reactions to Hymenoptera stings are classified into normal local reactions, large local reactions, systemic toxic reactions, systemic anaphylactic reactions, and unusual reactions. For most venom-allergic patients an anaphylactic reaction after a sting is very traumatic event, resulting in an altered health-related quality of life. Risk factors influencing the outcome of an anaphylactic reaction include the time interval between stings, the number of stings, the severity of the preceding reaction, age, cardiovascular diseases and drug intake, insect type, elevated serum tryptase, and mastocytosis. Diagnostic tests should be carried out in all patients with a history of a systemic sting reaction to detect sensitization. They are not recommended in subjects with a history of large local reaction or no history of a systemic reaction. Testing comprises skin tests with Hymenoptera venoms and analysis of the serum for Hymenoptera venom-specific IgE. skin testing with incremental venom concentrations is recommended. If diagnostic tests are negative they should be repeated several weeks later. Serum tryptase should be analyzed in patients with a history of a severe sting reaction.