Aortic prosthetic graft thrombosis after bee sting-induced anaphylaxis

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.