Lin Cheng-Jui, Wu Chih-Jen, Chen Han-Hsiang, Lin Hsin-Chang
Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital and Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
South Med J. 2011 May;104(5):378-9. doi: 10.1097/SMJ.0b013e318213ebee.
Wasp bites usually bring temporary discomfort and pain, but on occasion, they can cause serious infections and fatal allergic reactions. We report on a patient who experienced massive wasp stings and developed multiple organ failure, including acute kidney, hepatic failure, and circulatory collapse 4 days later. He was treated with aggressive fluid resuscitation, inotropic agent, intravenous injection of steroids, broad-spectrum antibiotics, and hemodialysis. After intensive treatment, his liver function recovered one month later. Recovery of renal function was delayed, and the patient needed temporary regular hemodialysis. The pathology of kidney biopsy showed acute tubulointerstitial nephritis. This case shows that toxic reactions following massive wasp attacks may happen several days after the fact and result in severe, multiorgan system dysfunction.
黄蜂叮咬通常会带来暂时的不适和疼痛,但偶尔也会导致严重感染和致命的过敏反应。我们报告了一名患者,他遭受了大量黄蜂蜇伤,4天后出现多器官功能衰竭,包括急性肾、肝功能衰竭和循环衰竭。他接受了积极的液体复苏、血管活性药物、静脉注射类固醇、广谱抗生素和血液透析治疗。经过强化治疗,他的肝功能在1个月后恢复。肾功能恢复延迟,患者需要定期进行临时血液透析。肾活检病理显示为急性肾小管间质性肾炎。该病例表明,大量黄蜂攻击后的毒性反应可能在数天后发生,并导致严重的多器官系统功能障碍。