Hymenoptera stings: a study of clinical profile, complication and outcome from a teaching hospital of central Nepal

• Main Authors: M Ghimire, B Pahari, N Paudel, G Das, SK Sharma
• Format: Article
• Language: English
• Published: College of Medical Sciences 2014-04-01
• Series: Journal of College of Medical Sciences-Nepal
• Subjects: Hymeneptora stings; complication; outcome
• Online Access: http://www.nepjol.info/index.php/JCMSN/article/view/10210

<p><strong>Background <br /> </strong>Hymenoptera sting is a common health hazard in the tropics. Wasp and Bee stings can produce symptoms ranging from local allergic reactions to serious complications including anaphylaxis and multiple organ dysfunction syndromes.</p> <p><strong>Objective <br /> </strong>To evaluate the clinical profile, management and early outcome of patients with gallbladder cancer.</p> <p><strong>Methods <br /> </strong>We prospectively analyzed all the consecutive patients with Hymenopterid sting (Wasp and Bee stings), who were admitted in Nephrology Unit in college of Medical Sciences Teaching hospital over a period of two year; from June 2010 to May 2012. Data including demographic profile, clinical profile, complications and outcomes associated with the Hymenopterid stings were entered in a designated profroma and were analyzed.</p> <p><strong>Results <br /> </strong>A total of 15 cases with Hymenopterid stings (Wasp and Bee stings) were analyzed. Majority of the cases were females (n=8). The male to female ratio was 0.88. The mean age of the case was 37.1&plusmn; 17.38years. Most of the cases (n=11) were younger subjects d"45 years and majority of them felt in the age group of 21-30 years; (n=4). Mean number of stings (Wasp or Bee stings), were 46 &plusmn; 18.4 (12-74) and the mean time to reach the hospital from the bite time was 78.23&plusmn;82.24 hours (30 minutes-13 days). Black Wasps were the commonest species to inflict the stings in (n=10) cases and Bees in (n=5) cases. The Hymenoptera stings were observed more frequently in the month of July to September in (n=8). The commonest site of bite was head and face seen in (n=11) cases. Among the clinical presentations the commonest clinical presentation was local burning pain and pruritus which was present in all the cases (n=15) followed by nausea (n=10). The commonest clinical sign was bipedal edema which was seen in (n=7) cases. Low Hb (defined as Hb &lt;10gm/dl) was seen in (n=5) cases of Hymenopterid stings. Low platelet (defined as Platelet &lt; 100X109/L) was documented in (n=10) cases. Serum creatinine &gt;1.5mg /dl was seen in (n=7) cases. Low serum albumin (defined as Serum Albumin (&lt;3.5gm/dl) was seen in (n=6) cases. Among the complications, the most common complication was Hepatitis which was seen in (n=9) cases, followed by Acute Kidney Injury. There was no mortality associated with Hymenopterid stings in our study. However 1 patient left against medical advice.</p> <p><strong>Conclusion <br /> </strong>Black Wasps were the commonest species to inflict the stings in (n=10) cases. The most common complication of Hymenoptera sting was Hepatitis, which was seen in (n=9) of cases, followed by Acute Kidney Injury. Majority of complications were seen in Wasp stings which caused significant morbidity. No mortality was observed in our study except one case; that left hospital against medical advice.<em> </em></p> <p><em>Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 17-24</em> &nbsp;<br /> DOI:&nbsp;<a href="http://dx.doi.org/10.3126/jcmsn.v9i3.10210">http://dx.doi.org/10.3126/jcmsn.v9i3.10210</a> <strong>&nbsp;</strong></p>