Wasp Stings with Multiple Organ Dysfunction in Children

Objective: Allergic reactions from wasp stings usually occur shortly after the stings. Serious and less common systemic mani- festations including multiple organ dysfunction can also occur at a later time. Methods: Medical records of pediatric patients admitted because of wasp stings into the Faculty of Medicine Siriraj Hospital from 2000 to 2009 were reviewed. Results: Nine cases were admitted because of systemic reactions from wasp stings. Most required only intravenous fluid and antihistamine. Two young children developed multiple organ dysfunction more than 24 hours after multiple stings. Both patients required artificial ventilation. The first patient received 20 days of renal replacement therapy and recovered completely. The second patient developed sepsis during peritoneal dialysis and died on the 34th day. Conclusion: Clinicians should be aware that young children with multiple stings are at risk of multiple organ dysfunction. We suggest hospitalization for at least 48 hours to provide early detection of complications and management.