Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Xiang-Dong Li, Zheng Liu, Ying Zhai, Ming Zhao, Hai-Yan Shen, Yi Li, Bo Zhang, Tao Liu
Department of Nephrology, 3201 Affiliated Hospital of Medical College of Xi’an Jiaotong University, Hanzhong, Shaanxi, China (mainland)
Am J Case Rep 2015; 16:371-373
The Asian giant hornet is the largest wasp species in the world. Its stings can cause acute interstitial nephritis and acute renal failure. From July to October, 2013, Asian giant hornet attacks have killed 42 people and injured 1675 people with their powerful venomous stings in Hanzhong, Ankang, and Shangluo, three cities in the southern part of Shaanxi Province, China.
CASE REPORT: We report here a case of a 42-year-old man with acute interstitial nephritis following multiple Asian giant hornet stings. On admission, the patient had difficulty breathing, headache, and numbness in both limbs (arm and leg). He was treated in the Emergency Department and Department of Nephrology with plasma exchange and dialysis within 24 hours after being stung. A kidney biopsy revealed acute interstitial nephritis with interstitial infiltrations of eosinophils and lymphocytes. After intensive treatment, his liver function recovered within 10 days. Along with oral methylprednisolone, his renal function recovered 1 month later.
CONCLUSIONS: This case shows that acute interstitial nephritis happens several days after being stung. Since the number of deaths in southern Shaanxi province is much higher than other places, our report draws the attention of fellow clinicians to the acute interstitial nephritis following multiple Asian giant hornet stings.
Keywords: Adult, Acute Disease, Animals, Biopsy, Humans, Insect Bites and Stings - complications, Male, Nephritis, Interstitial - therapy, Renal Dialysis, Wasps