Acute interstitial nephritis, toxic hepatitis and toxic myocarditis following multiple Asian giant hornet stings in Shaanxi Province, China.

Zheng Liu,Xue-Li Wang,Hai-Yan Shen,Ying Zhai,Xiang-Dong Li,Ming Zhao,Yi Li,Bo-Hui Guo,Tao Liu

doi:10.1007/s12199-016-0516-4

Zheng Liu, Xue-Li Wang + Show 7 more

Open Access

https://doi.org/10.1007/s12199-016-0516-4

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Abstract

During July to October 2013, the Asian giant hornet has killed 42 and injured 1,675 people in the southern part of Shaanxi Province, China. This study investigated this unusual and frequent public health event. During the 3 months, 103 patients with severe Asian hornet stings were hospitalized in our hospital. Clinical data were collected using a standardized data collection form which included sex, age, length of hospital stay and medical recorder. After physical examination and laboratory investigation, 25.2, 46.6 and 44.7% of the patients were found with varying degrees of acute interstitial nephritis, acute toxic hepatitis and acute toxic myocarditis, respectively. After timely and appropriate treatment including removal of the stings and the use of intravenous methylprednisolone and antihistamines, the kidney function, liver function and heart function of 99 patients recovered within 1 month, while four patients died. This study provided a good opportunity for recognizing the effect of Asian giant hornet stings and evaluating this serious public health event.

Highlights

Wasps are found almost in all parts of the world
After physical examination and laboratory investigation, 25.2, 46.6 and 44.7 % of the patients were found with varying degrees of acute interstitial nephritis, acute toxic hepatitis and acute toxic myocarditis, respectively
This study provided a good opportunity for recognizing the effect of Asian giant hornet stings and evaluating this serious public health event

Summary

Introduction

Wasps are found almost in all parts of the world. They play an important role in the balance of natural ecosystems through pollination, natural pest control and biodiversity [1, 2]. The most common types of wasps are hornets, yellow jackets and paper wasps. The Asian giant hornet (Vespa mandarinia) belongs to hornets and is the world’s largest eusocial wasps (Fig. 1). They are mainly found throughout Eastern Asia, but have appeared in France, Spain, Portugal, Belgium, Italy, and Germany [4]. The Asian giant hornet stings cause local reactions and anaphylaxis. Some cases from Japan and Thailand have caused severe clinical complications such as acute interstitial nephritis (AIN), acute toxic hepatitis (ATH), acute toxic myocarditis (ATM) and multiple organ dysfunction syndrome (MODS) [5,6,7]

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