Clinical and biochemical profile of wasp sting patients in a tertiary care hospital

Authors

  • Parash Ullah Department of Gastroenterology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh https://orcid.org/0000-0001-6397-9736
  • Habiba Kabir Department of Internal Medicine, Bangladesh Medical University, Dhaka, Bangladesh https://orcid.org/0009-0003-4989-4287
  • M. M. Jahangir Alam Department of Medicine, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh
  • Md. Shafiqul Bari Department of Medicine, Dhaka Medical College, Dhaka. Bangladesh
  • Fazle Rabbi Chowdhury Department of Internal Medicine, Bangladesh Medical University, Dhaka, Bangladesh https://orcid.org/0000-0001-9579-0030

DOI:

https://doi.org/10.3329/bsmmuj.v18i3.78955

Keywords:

wasp sting, rhabdomyolysis, acute kidney injury, Vespa affinis

Abstract

Background: Wasp stings and the resulting allergic reactions are common reasons for visiting the emergency department. Stings can be fatal due to multi-system involvement. In our country, the impact of massive wasp stings has been significantly underestimated and has not been systematically investigated. This study aimed to identify the clinical presentations and biochemical profiles of patients experiencing wasp stings in our context.

Methods: This case-series study was conducted at the department of medicine in Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh. The research involved species identification, based on photographic evidence, in conjunction with the patient’s history and informed consent. The study documented the socio-demographic history, details of the wasp bite, and related complications.

Results: Among the 30 patients studied, there were 22 males, and 8 females, mean age 36.5 (13.1) years. The average number of stings was 57.6 (114.7) (2 to 500 bites), and hospital arrival time ranged from 15 minutes to 8 days. All the patients experienced local pain, swelling, myalgia and rhabdomyolysis. Systemic complications, such as acute kidney injury, were observed in 20% of cases, with half of these requiring hemodialysis. Biochemically, elevated creatine phosphokinase, hyponatremia, and hyperkalemia were frequent. Most of the stings were attributed to Vespa affinis (21; 70%) and Vespa tropica (7; 23%).

Conclusion: Rhabdomyolysis was a universal finding in wasp sting cases. Delayed arrival to the hospital significantly increases systemic complications, with acute kidney injury emerging as the most common severe outcome. Early medical intervention is necessary to minimise these risks.

Downloads

Download data is not yet available.

References

Liu Z, Li XD, Guo BH, Li Y, Zhao M, Shen HY, Zhai Y, Wang XL, Liu T. Acute interstitial nephritis, toxic hepatitis and toxic myocarditis following multiple Asian giant hornet stings in Shaanxi Province, China. Environ Health Prev Med. 2016 Jul;21(4):231-236. doi: https://doi.org/10.1007/s12199-016-0516-4

Ryakitimbo A, Kennedy M, Shao E, Itana ME, Mbwasi R, Kinabo G, Yeates K, Kilonzo K. Acute kidney injury in a Tanzanian boy following multiple bee stings in resource-limited setting: a case report. Oxf Med Case Reports. 2018 Oct 3;2018(10):omy070. doi: https://doi.org/10.1093/omcr/omy070

Forrester JA, Holstege CP, Forrester JD. Fatalities from venomous and nonvenomous animals in the United States (1999-2007). Wilderness Environ Med. 2012 Jun;23(2):146-152. doi: https://doi.org/10.1016/j.wem.2012.02.012

Forrester JA, Weiser TG, Forrester JD. An Update on Fatalities Due to Venomous and Nonvenomous Animals in the United States (2008-2015). Wilderness Environ Med. 2018 Mar;29(1):36-44. doi: https://doi.org/10.1016/j.wem.2017.10.004. Erratum in: Wilderness Environ Med. 2018 Jun;29(2):284. doi: https://doi.org/10.1016/j.wem.2018.03.005

Vetter RS, Visscher PK, Camazine S. Mass envenomations by honey bees and wasps. West J Med. 1999 Apr;170(4):223-237. PMID: 10344177

Fitzgerald KT, Flood AA. Hymenoptera stings. Clin Tech Small Anim Pract. 2006 Nov;21(4):194-204. doi: https://doi.org/10.1053/j.ctsap.2006.10.002

Bhatta N, Singh R, Sharma S, Sinnha A, Raja S. Acute renal failure following multiple wasp stings. Pediatr Nephrol. 2005 Dec;20(12):1809-1810. doi: https://doi.org/10.1007/s00467-005-2044-0

Zhang L, Tang Y, Liu F, Shi YY, Cao Y, Xu H, Fu P. Multiple organ dysfunction syndrome due to massive wasp stings: an autopsy case report. Chin Med J (Engl). 2012 Jun;125(11):2070-2072. PMID: 22884081

Chu Roy M, Chatterjee M, Deb S, Pandit N. Encephalitis following wasp sting. Indian J Pediatr. 2010 Oct;77(10):1193-1194. doi: https://doi.org/10.1007/s12098-010-0201-3

Xuan BH, Mai HL, Thi TX, Thi MT, Nguyen HN, Rabenou RA. Swarming hornet attacks: shock and acute kidney injury--a large case series from Vietnam. Nephrol Dial Transplant. 2010 Apr;25(4):1146-1150. doi: https://doi.org/10.1093/ndt/gfp583

Lin CJ, Wu CJ, Chen HH, Lin HC. Multiorgan failure following mass wasp stings. South Med J. 2011 May;104(5):378-379. doi: https://doi.org/10.1097/SMJ.0b013e318213ebee

Diaz JH. Hymenopterid bites, stings, allergic reactions, and the impact of hurricanes on hymenopterid-inflicted injuries. J La State Med Soc. 2007 May-Jun;159(3):149-157. PMID: 17694935

Thiruventhiran T, Goh BL, Leong CL, Cheah PL, Looi LM, Tan SY. Acute renal failure following multiple wasp stings. Nephrol Dial Transplant. 1999 Jan;14(1):214-217. doi: https://doi.org/10.1093/ndt/14.1.214

Paudel B, Paudel K. A study of wasp bites in a tertiary hospital of western Nepal. Nepal Med Coll J. 2009 Mar;11(1):52-56. PMID: 19769240

Pérez Pimiento AJ, Prieto Lastra L, Rodríguez Cabreros MI, Vásquez Bautista AA, García Cubero A, Calvo Manuel E. Systemic reactions to wasp sting: Is the clinical pattern related to age, sex and atopy? Allergol Immunopathol (Madr). 2007 Jan-Feb;35(1):10-14. doi: https://doi.org/10.1157/13099089. Erratum in: Allergol Immunopathol (Madr). 2007 Mar-Apr;35(2):51. PMID: 17338896

Witharana EW, Wijesinghe SK, Pradeepa KS, Karunaratne WA, Jayasinghe S. Bee and wasp stings in Deniyaya; a series of 322 cases. Ceylon Med J. 2015 Mar;60(1):5-9. doi: https://doi.org/10.4038/cmj.v60i1.7406

Xie C, Xu S, Ding F, Xie M, Lv J, Yao J, Pan D, Sun Q, Liu C, Chen T, Li S, Wang W. Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases. PLoS One. 2013 Dec 31;8(12):e83164. doi: https://doi.org/10.1371/journal.pone.0083164

Vikrant S, Jaryal A, Parashar A. Mortality due to mass Hymenoptera attacks: A serious but underrecognized public health problem in a mountainous state of India. Indian J Public Health. 2019 Apr-Jun;63(2):154-156. doi: https://doi.org/10.4103/ijph.IJPH_222_18

Arya A, Jindal A. Acute kidney injury and rhabdomyolysis due to multiple wasp stings. Indian J Crit Care Med. 2014 Oct;18(10):697-698. doi: https://doi.org/10.4103/0972-5229.142181

Ullah P, Chowdhury A, Isha IT, Mahmood S, Chowdhury FR, Zeesan-ul-Abir M, Manna AA, Patwary MI. Wasp stings (Vespa affinis) induced acute kidney injury following rhabdomyolysis in a 25-year-old woman. J Emerg Pract Trauma. 2015;2(2):55–57. doi: https://doi.org/10.15171/jept.2016.08

Published

2025-07-24

How to Cite

Ullah, P., Kabir, H., Alam, M. M. J., Bari, M. S., & Chowdhury, F. R. (2025). Clinical and biochemical profile of wasp sting patients in a tertiary care hospital . Bangabandhu Sheikh Mujib Medical University Journal, 18(3), e78955. https://doi.org/10.3329/bsmmuj.v18i3.78955

Issue

Section

Research Article

Most read articles by the same author(s)

Similar Articles

1 > >> 

You may also start an advanced similarity search for this article.