Acute renal failure: A fatal complication following multiple hornet stings

Abstract

Hornet (wasp) stings are common worldwide. Most of the time they produce non fatal local allergic reactions, but sometimes can be fatal when mass stinging causes multisystem involvement We report a case of acute renal failure (ARF) following multiple hornet stings. A 28 year male presented with pain and swelling of the body following multiple hornet stings. After 3 days, he developed progressive decrease in urine output with dark colored urine. Physical examination revealed oedematous swelling mainly on exposed parts. On investigating, progressive elevations in renal function test was found. The markers of muscle injury were grossly elevated and liver enzymes were also deranged. These findings suggest multisystem involvement predominantly ARF secondary to rhabdomyolysis. After eight sessions of hemodialysis the patient improved completely. Timely intervention of multiple hornet stings causing ARF with multiorgan involvement by hemodialysis prevents mortality as well as other complications.