CASE REPORT


A Case of Multiple Wasp Stings Causing Multi-organ Dysfunction Syndrome



Nabin Basnet1, *, Binod Pantha2, Sanjeev Acharya1, Barsha Shrestha3, Rishi Kafle3
1 Department of Nephrology, Sumeru Kidney Hospital, Sumeru, Nepal
2 Department of Internal Medicine, National Academy of Medical Sciences, Bir Hospital, Nepal
3 Department of Nephrology, National Kidney Centre, Kathmandu, Nepal


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Creative Commons License
© 2019 Basnet et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Nephrology, Sumeru Kidney Hospital, Sumeru, Nepal; Tel: 977-9851037521;
E-mail: dr.nabinbasnet@gmail.com


Abstract

Wasp stings occur commonly and uncomplicated cases are generally managed at local health centers. Complicated cases are referred to tertiary hospitals for multi-specialty care. We report a case of a 30-year old gentleman from a remote center in Nepal who had multiple wasp stings and developed oligo-anuric acute kidney injury, liver failure, and rhabdomyolysis. He was promptly referred to our hospital after initial resuscitation. At our hospital, he was treated with intensive conventional supportive care and specific organ-supportive care including N-Acetylcysteine infusion and hemodialysis. With the treatment given, the general condition of the patient as well as liver function improved within the first week. However, the recovery of kidney function and urine output lagged behind. The patient showed signs of improvement in kidney function at the end of the third week and completely recovered by the 40th day of treatment.

Keywords: Wasps, Bites, Stings, Acute kidney injury, Multiple organ failure, Renal dialysis.