Clinical and biochemical profile of wasp sting patients in a tertiary care hospital

Background: Wasp stings and the resulting allergic reactions are common reasons for visiting the emergency department. Stings can be fatal due to multi-system involvement. In our country, the impact of massive wasp stings has been significantly underestimated and has not been systematically investigated. This study aimed to identify the clinical presentations and biochemical profiles of patients experiencing wasp stings in our context. Methods: This case-series study was conducted at the department of medicine in Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh. The research involved species identification, based on photographic evidence, in conjunction with the patient’s history and informed consent. The study documented the socio-demographic history, details of the wasp bite, and related complications. Results: Among the 30 patients studied, there were 22 males, and 8 females, mean age 36.5 (13.1) years. The average number of stings was 57.6 (114.7) (2 to 500 bites), and hospital arrival time ranged from 15 minutes to 8 days. All the patients experienced local pain, swelling, myalgia and rhabdomyolysis. Systemic complications, such as acute kidney injury, were observed in 20% of cases, with half of these requiring hemodialysis. Biochemically, elevated creatine phosphokinase, hyponatremia, and hyperkalemia were frequent. Most of the stings were attributed to Vespa affinis (21; 70%) and Vespa tropica (7; 23%). Conclusion: Rhabdomyolysis was a universal finding in wasp sting cases. Delayed arrival to the hospital significantly increases systemic complications, with acute kidney injury emerging as the most common severe outcome. Early medical intervention is necessary to minimise these risks.