A middle-aged man’s unlucky encounter with honeybees that led to allergic MI — or Kounis syndrome — has prompted a warning to consider the “uncommon” diagnosis in patients with multiple bee stings.

Doctors in India have reported the case of a 50-year-old who presented to hospital with facial puffiness, swelling on both arms and difficulty breathing after sustaining an estimated 100-150 honeybee stings.

They also noted he was drowsy with bradycardia and hypotension, which led to immediate intubation with respiratory support and treatment with steroids, epinephrine and antihistamines.

“The patient became conscious 30 minutes later and mentioned experiencing chest pain. An ECG suggested inferior and posterior wall MI,” they wrote in Cureus.