Acute Liver Injury, Rhabdomyolysis and Acute Renal Failure in a Toddler due to Multiple Stings by Vespa affinisCorrespondence Address :
Dr. SR Ravikiran,
Professor, Department of Paediatrics, Kasturba Medical College, Manipal Academy of Higher Education,
Mangalore-575001, Karnataka, India.
Vespa affinis stings are known to produce local as well as systemic toxic manifestations including haemolysis, rhabdomyolysis, renal injury, hepatic toxicity and encephalopathy. However, very few pediatric cases of Vespa affinis stings have been reported. We report an unusual case of a toddler with hornet stings (10 in number) who presented to our hospital 72 hours after the sting and met with a fatal outcome. At the time of presentation, child was in altered sensorium and shock with multiple necrotic sting marks. Blood investigations were suggestive of acute renal failure with dyselectrolytemia, rhabdomyolysis and toxic liver injury. Child was managed conservatively with intravenous fluids, renal sparing antibiotics, inotropes, fresh frozen plasma and intravenous high dose steroid (Methyl Prednisolone 30 mg/kg/dose). However, the child deteriorated and had a cardiac arrest the same day. She was resuscitated, intubated and connected to a ventilator. The condition worsened and the child succumbed to death. Since there is no specific treatment, a rare case of hornet bite with acute toxic liver injury and rhabdomyolysis could be a challenge to treat.
Hornet sting, Multi-organ dysfunction, Necrotic sting marks
Neha, SR Ravikiran, Sharath Manya, Kiran Baliga, Kamalakshi G Bhat. ACUTE LIVER INJURY, RHABDOMYOLYSIS AND ACUTE RENAL FAILURE IN A TODDLER DUE TO MULTIPLE STINGS BY VESPA AFFINIS. Journal of Clinical and Diagnostic Research [serial online] 2019 February [cited: 2019 Apr 19 ]; 13:SD01-SD03. Available from
Date of Submission: Nov 14, 2018
Date of Peer Review: Dec 04, 2018
Date of Acceptance: Dec 11, 2018
Date of Publishing: Feb 01, 2019
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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