Electrocardiographic Changes Associated With Multiple Yellow Jacket Stings

Sf, Rowe; Ke, Greer; Rh, Hodge

doi:10.1097/00007611-197904000-00030

Cited by 10 publications

(4 citation statements)

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“…Together, they are responsible for the myriad presentation of wasp sting. The more severe systemic complications include renal (acute renal failure, nephrotic syndrome, and renal tubular acidosis) [ 11 , 12 ], cardiac (myocarditis, myocardial infarction, and arrhythmias) [ 13 , 14 ], hepatic (centrilobular necrosis and pericholangitis) [ 15 , 16 ], neurological (stroke, Guillian-Barre syndrome, and acute encephalopathy) [ 17 , 18 ], hematological (hemolysis, DIC, and thrombocytopenia) [ 19 - 21 ], and vasculitis [ 22 ]. Our patient had several of these systemic reactions.…”

Section: Discussionmentioning

confidence: 99%

Multi-organ dysfunction secondary to severe wasp envenomation

et al. 2015

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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.

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Section: Discussionmentioning

confidence: 99%

Multi-organ dysfunction secondary to severe wasp envenomation

et al. 2015

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“…The amines include acetylcholine, histamine, serotonin and catecholamines (adrenaline, noradrenaline and dopamine). The proteins and polypeptides are primarily kinins and enzymes, including phospholipase A and B, proteases, hyaluronidase and a mast‐cell degranulating peptide, mastoporan 17–34 . Specific toxins (the haemolytic, neurotoxic Orientotoxin 1 ) and a glucagon‐like factor 1 have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Orientotoxin, from venom of the Oriental hornet ( V. orientalis ), is demonstrated by in vitro studies to block presynaptic neurotransmitter release 34 and one case reports bilateral optic neuritis 18 . Self‐limiting cardiac arrhythmias 19 and features of Reye's syndrome 20 have been reported in association with multiple vespid stings.…”

Section: Discussionmentioning

confidence: 99%

Massive European wasp envenomation of a child

Levick

Braitberg

1996

Emergency Medicine

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Envenomation is a unique area of emergency medicine which interfaces acute emergency care with zoological research and public education. A considerable amount is known about envenomation by the snakes and spiders of Australia, which are among the most venomous in the world. There is little known, however, about massive envenomation by the European wasp (species Vespula germanica, family Vespidae), a recently introduced, aggressive and venomous vespid wasp. Allergy to bee, wasp and ant venom (order Hymenoptera) is well reported in the literature but there has been no documentation of systemic allergic reactions following massive vespid envenomation. Massive envenomation by vespid wasps in Australia has not been reported, although there are international reports of serious morbidity and a number of fatalities. This paper reports a massive European wasp envenomation in Melbourne and reviews the international literature. In this case, in contrast to the literature on massive vespid wasp envenomation, there is predominance of central nervous system toxicity with no major metabolic disturbance. The management of massive vespid envenomation includes standard supportive care and close laboratory monitoring for early evidence of haemolysis, rhabdomyolysis and metabolic derangement, which may significantly precede any clinical deterioration. Serious complications may be delayed and it is advised to follow up patients for 72 hours. There is potential for further research into vespid wasp venom and a need for increased public awareness of preventative strategies in Australia.

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“…Multi organ failure, rhabdomyolysis, electrocardiographic changes, acute kidney injury and myocardial infarction are well known complications of mass envenomation due to hymenoptera sting [8][9][10][11]. There are reports of acute kidney injury, myocardial infarction, severe anaphylaxis and bowel gangrene after giant Asian honeybee or wasp sting in Sri Lanka [8,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%