Multi-organ dysfunction secondary to severe wasp envenomatio
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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.

Case :
A 32-year-old male presented to the emergency department (ED) of our hospital with breathing difficulty and decreased urine output. One day prior to the arrival in our hospital, this patient had been bitten by multiple wasps (exact species could not be identified) while climbing a coconut tree. He had developed breathing difficulty and generalized swelling immediately after this incident. He was taken to a nearby hospital where he was treated in the emergency unit and send home the same day as he felt ‘better’. The next day, he noticed a decrease in his urine output and progressive shortness of breath and hence was referred to our hospital.....
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