Fatal case of wasp stinging

Abstract

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.