Abstract
Wasp sting is not an uncommon incident. Around 56% to 94% of the population is stung at least once in their lifetime by a member of the order Hymenoptera which includes wasps, bees, and ants. The response to a wasp sting may vary from mild local reaction to severe systemic and anaphylactic reactions. The clinical picture and mortality rate tend to be more severe in adults compared to children. We present a 32-year-old agricultural worker who was bitten by multiple wasps while on a coconut tree. In spite of the heavy load of venom due to the multiple bites, the patient did not develop anaphylaxis. However, a delayed reaction did occur within 48 h in the form of severe multi-organ dysfunction. There was significant improvement by around 2 weeks; but it took another 6 months for the serum creatinine to normalize. This case highlights the occupational risk of Hymenoptera envenomation, the life-threatening complications that may follow and which may even be delayed as was the case with this patient, and the value of emergency care and intensive management which can result in a favorable clinical outcome.
Highlights
Wasp sting is not an uncommon incident
The response to Hymenoptera stings are classified as normal local reactions, large local reactions, systemic anaphylactic reactions, systemic toxic reactions, and unusual reactions [2,3]
The risk for systemic reaction is increased if preceded by a sting within the last 2 months even if the first sting is well tolerated [7]
Summary
Wasp sting is not an uncommon incident. Wasps together with bees and ants belong to the order Hymenoptera. We present a young male who had multi-organ dysfunction secondary to multiple wasp stings. One day prior to the arrival in our hospital, this patient had been bitten by multiple wasps. This was a young male who was engaged in agricultural work. Significant for severe renal failure, hemolysis, rhabdomyolysis, and liver dysfunction His blood urea was 126 mg/dL (N: 20 to 40 mg/dL) and serum creatinine was 6.1 mg/dL (N: 0.5 to 1.4 mg/dL). Though urine output had been established, it took another 6 months for his serum creatinine value to normalize Throughout his hospital stay, the patient was hemodynamically stable and did not require any assisted ventilation
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