The Case of Ronald McDonald and the Mysterious Dizziness


Name of patient: Ronald McDonald

Age: 35

Symptoms :
  • bumps on arms
  • breathing difficulty
  • big swells on arms
  • itchiness
  • throat tingling
  • dizziness
  • chest pain and cramps
  • vomiting, diarrhea

Diagnosis method : Checked blood pressure and heart rate. Did a blood test to determine if insect venom is present. Did a blood count to determine if there is an infection.

Treatment: Injecting epinephrine ( adrenaline) which opens up the airways in the lungs which in an anaphylactic shock would be closing, it also keeps the heart beating. Apply steroids such as Decadron, IV Fluid. Use pressor agents (which cause the heart to increase its beating and strength) such as Dopamine for hypotension.


One beautiful summer day I was walking around The Allergy Police Clinic when suddenly a clown floundered in. He looked like Ronald McDonald from McDonald's. He looked almost asleep, I immediately knew something was wrong so I brought him in to my consultation room and asked what was the matter . He said that when he got up this morning he felt very itchy around his arms and dizzy, he also noticed that his arms were swelling. After he noticed these things in the morning he threw up and had diarrhea. He complained about chest pains and a throat tingling. I noticed some bumps on his arms and asked him if he knew where they had come from. He replied "I have no idea I just woke up like this!" Without warning he fell down, my first reaction was to check his pulse and breathing. He had a very rapid pulse but no breathing so I immediately got the breathing mask that was on my desk and put it on him. I immediately started to perform tests including blood pressure measurement, he had a very low one, a blood test to check for poisons in the blood and a blood count to see if there was an infection somewhere. There was no infection but there was bee venom in his blood. I was sure that what I was seeing was a clown in anaphylactic shock, something I had never seen before ( the clown part I mean.)

Anaphylactic shock is what happens to someone who is seriously allergic to an insect sting. When the insect stings it releases its venom into the blood stream which brings it throughout the body, the insect venom encounters mast cells in the tissues of the body, when it does this it and the antibodies that come to try to stop the insect venom make the mast cells release a chemical called immunoglobulin E which triggers this airway closing affect.

I injected epinephrine into the clown since epinephrine or adrenaline naturally makes your airways open up and adds pressure to the flow of blood. He started breathing a bit but not enough to satisfy his needs, so I injected Dopamine to increase his heartbeat. luckily this boosted his body up enough to make him breathe normally again.

When Ronald regained full consciousness I told him all about his condition. He said " I had no idea that I was allergic to a bee venom, I've never been stung before. I bet it had something to do with my neighbors honey bee farm. Wait a sec how come you didn't find a bee singer, don't they stay in a persons skin?" I replied "Yes but because you were stung in your sleep you probably pulled the stinger out when you tossed and turned in bed."

The End

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Human Diseases and Conditions by: Niel Izenberg: Bites and Stings page131-133