Acute renal failure following multiple wasp bites

Gunasekara, Wdvn; Ratnatunga, N; Abeygunawardena, AS

doi:10.4038/sljch.v36i2.54

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…But in Case 2, the patient deteriorated over hours with multiple organ dysfunction and metabolic derangements. Multiple organ dysfunction and acute kidney injury has been reported after wasp stings [ 8 , 10 - 12 ]. Usually these complications are irreversible, except in a rare case of recovery after being anuric for 5 days [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Fatal acute pulmonary oedema and acute renal failure following multiple wasp/hornet (Vespa affinis) stings in Sri Lanka: two case reports

Kularatne¹,

Kannangare²,

Jayasena³

et al. 2014

J Med Case Reports

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IntroductionVespa affinis is a hornet widely distributed in Sri Lanka and it is responsible for the highest number of deaths related to Hymenoptera stings. Apart from the early reactions, victims often die in hospital many hours later due to complications such as myocardial infarction and multiple organ failure. Increased microvascular permeability and acute pulmonary oedema as the primary pathology is less known in hornet envenoming.Case presentationHere, we report clinical and postmortem findings of two Sinhalese patients, a 48-year-old husband and his 46-year-old wife, who both died following a massive attack by hornets 32 hours and 9 hours after the incidence respectively. At postmortem examination, both patients had pleural effusions, acute pulmonary oedema and red cell casts in their urine. Their coronary arteries and histology of myocardium were normal.ConclusionEarly recognition of acute pulmonary oedema in hornet stings is needed with implementation of crucial treatments to avert deaths.

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Section: Discussionmentioning

confidence: 99%

Fatal acute pulmonary oedema and acute renal failure following multiple wasp/hornet (Vespa affinis) stings in Sri Lanka: two case reports

Kularatne¹,

Kannangare²,

Jayasena³

et al. 2014

J Med Case Reports

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“…9 A range of clinical complications ranging from nonspecific skin lesions to anaphylactic shock can occur, in a previously sensitized person, following even a single hymenopteran bite (Vespa affinis). 10 When there is a death, external examination for wasp stings, internal examination for organ failure and blood investigations for mast cell tryptase and Ig E levels will help the diagnosis. We report a fatal case of wasp sting with 32 skin lesions.…”

Section: Introductionmentioning

confidence: 99%

Fatal case of wasp stinging

Senanayake¹,

Senarathna²

2019

Sri Lanka J Forensic Med, Sci & Law

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History -While a 2 year and 9 month old girl was going for a bath with the grandmother, they encountered a wasp net on the ground. The wasps stung the child. She developed anaphylaxis and died during transport from local hospital eight hours after the attack.Postmortem examination-Thirty two skin lesions of 2-3 mm wide, circular, black macules were seen on back and limbs. Every black spot was surrounded with 0.5 -2cm size elevated red margin. Pink fluid in pleural cavities and peritoneal cavity, shock lungs and congested viscera were the only internal findings. Blood was hemolyzed and unsuitable for serum beta tryptase test. Based on the skin lesion, medical history and evidence of eye witness, the cause of death was pronounced as anaphylaxis following wasp attack.Conclusion-Familiarization with skin lesions of wasp stings are important for Srilankan forensic medicine practitioners. Collection and preservation of ante mortem blood samples or early postmortem blood sample with serum separation by centrifuging is advisable in suspected anaphylaxis cases for future confirmatory investigation.

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“…Multi organ failure, rhabdomyolysis, electrocardiographic changes, acute kidney injury and myocardial infarction are well known complications of mass envenomation due to hymenoptera sting [8][9][10][11]. There are reports of acute kidney injury, myocardial infarction, severe anaphylaxis and bowel gangrene after giant Asian honeybee or wasp sting in Sri Lanka [8,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%