Acute kidney injury due to multiple wasp stings: A case report

Abstract

Wasp stings are a well-known form of envenomation in tropical as well as subtropical countries like Bangladesh. Wasps and bees are venomous arthropods belonging to the order Hymenoptera. The order consists of three families: Apidae (bees), Vespidae (wasps), and Formicidae (ants).1 In most of cases, wasp or bee sting victims develop minor, self-limiting, and localized symptoms. Pain, tissue necrosis, and anaphylactic reactions are well-recognized, common features.2 The skin is the most commonly affected organ. Wasp venom causes both local and systemic reactions, but acute kidney injury (AKI) is the most serious complication, with a 20% mortality rate. More serious complications like intravascular hemolysis, rhabdomyolysis, thrombocytopenia, acute kidney injury, liver function impairment, and myocardial infarction are less common but life-threatening conditions.3-5 Acute kidney injury due to wasp stings involves several mechanisms that include intravascular hemolysis, rhabdomyolysis, shock, and the direct toxic effects of the venom. Some patients may have been stung multiple times.6 The usual underlying lesion is acute tubular necrosis (ATN), and the course is characterized by complete recovery. Here we present a case of a girl, aged 4 years and 6 months who presented with AKI due to multiple wasp stings.