Successful Use of HA 330 II Extracorporeal Therapy in a Case of Multi-Organ Dysfunction Syndrome Following Multiple Hornet Stings<br>—<i>A</i> Case Report of Successful Bridging Therapy to Recovery

Hornet stings can result in severe local tissue injury, anaphylactic shock, and systemic inflammatory response syndrome (SIRS), potentially progressing to multi-organ dysfunction syndrome (MODS). We report a case of a 39-year-old gentleman who developed MODS following multiple hornet stings. His clinical course was complicated by the development of acute kidney injury, toxic hepatitis, disseminated intravascular coagulation (DIC), and cardiovascular instability. Laboratory findings revealed hyperkalaemia, metabolic acidosis, thrombocytopenia, hyperbilirubinemia, and elevated inflammatory markers. Initial management was focused on fluid resuscitation, haemodynamic support using inotropes, and initiation of sustained low-efficiency dialysis (SLED). Due to progressive worsening of acute kidney injury associated with haemodynamic instability, Continuous Veno-Venous Haemodiafiltration (CVVHDF) was initiated. The addition of plasmapheresis and HA 330 II haemoperfusion therapy led to marked clinical improvement with expedited weaning from supportive therapies, and the patient recovered without long-term complications. This case highlights the importance of early initiation of plasmapheresis in the management of MODS following hornet envenomation. Furthermore, the addition of haemoperfusion therapy facilitated the removal of cytokines, which contributed to improved clinical outcomes. Early institution of plasmapheresis and haemoperfusion may reduce morbidity and mortality associated with severe systemic hornet envenomation.