A study of wasp bites in a tertiary hospital of western Nepal.

Hymenopterid stings and subsequent allergic reactions including fatal anaphylaxis are common indications for emergency department visits worldwide. Besides that, sting can cause death as a result of multi-system involvement ranging from intravascular hemolysis, rhabdomyolysis, acute renal failure, hepatic dysfunction and occasionally thrombocytopenia and coagulopathy. Eleven cases (all male, age 35.5 +/- 15.2 years) of wasp bites admitted in the Manipal Teaching Hospital (MTH), Pokhara during 01st February, 2006 to 30th October, 2007 were enrolled in this study. Mean wasp bites number was 48.7 +/- 7.1 (11-100) and mean time to reach the hospital from the bite time was 69.1 +/- 149.7 hours (1.5 h-12 days). Nine patients developed acute renal failure (ARF) and secondary hypertension. Eight patients underwent hemodialysis. Two patients stuck by more than 75 stings developed refractory pulmonary edema and died in the course of treatment. Victims with lesser numbers of wasp envenomation, who received quick initiation of alkaline diuresis and intensive dialytic support had shorter hospital stay and less severe complications.