Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases.
BACKGROUND: Massive wasp stings have been greatly underestimated and have not been systematically studied. The aim of this study was to identify the clinical features and treatment strategies of severe wasp stings. METHODS AND FINDINGS: A multicenter retrospective study was undertaken in 35 hospital...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3877022?pdf=render |
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| author | Cuihong Xie Shabei Xu Fengfei Ding Minjie Xie Jiagao Lv Jihua Yao Dengji Pan Qian Sun Chenchen Liu Tie Chen Shusheng Li Wei Wang |
| author_facet | Cuihong Xie Shabei Xu Fengfei Ding Minjie Xie Jiagao Lv Jihua Yao Dengji Pan Qian Sun Chenchen Liu Tie Chen Shusheng Li Wei Wang |
| author_sort | Cuihong Xie |
| collection | DOAJ |
| description | BACKGROUND: Massive wasp stings have been greatly underestimated and have not been systematically studied. The aim of this study was to identify the clinical features and treatment strategies of severe wasp stings. METHODS AND FINDINGS: A multicenter retrospective study was undertaken in 35 hospitals and medical centers including 12 tertiary care hospitals and 23 secondary care hospitals in the Hubei Province, China. The detailed clinical data of 1091 hospitalized wasp sting patients were investigated. Over three-fourths (76.9%) of the cases had 10 or more stings and the in-hospital mortality of patients was 5.1%. Forty-eight patients died of organ injury following toxic reactions to the stings, whereas six died from anaphylactic shock. The in-hospital mortality in patients with >10 stings was higher than that of ≤10 stings (5.2% vs. 1.0%, p = 0.02). Acute kidney injury (AKI) was seen in 21.0% patients and most patients required blood purification therapy. Rhabdomyolysis was seen in 24.1% patients, hemolysis in 19.2% patients, liver injury in 30.1% patients, and coagulopathy in 22.5% patients. Regression analysis revealed that high creatinine level, shock, oliguria, and anemia were risk factors for death. Blood purification therapy was beneficial for patients with ≥20 stings and delayed hospital admission of patients (≥4 hours after sting). CONCLUSIONS: In China, most patients with multiple wasp stings presented with toxic reactions and multiple organ dysfunction caused by the venom rather than an anaphylactic reaction. AKI is the prominent clinical manifestation of wasp stings with toxic reaction. High creatinine levels, shock, oliguria, and anemia were risk factors for death. |
| first_indexed | 2024-04-12T23:11:18Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T23:11:18Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-13e5ac2f31f540c690f272c417ad7ddb2022-12-22T03:12:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01812e8316410.1371/journal.pone.0083164Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases.Cuihong XieShabei XuFengfei DingMinjie XieJiagao LvJihua YaoDengji PanQian SunChenchen LiuTie ChenShusheng LiWei WangBACKGROUND: Massive wasp stings have been greatly underestimated and have not been systematically studied. The aim of this study was to identify the clinical features and treatment strategies of severe wasp stings. METHODS AND FINDINGS: A multicenter retrospective study was undertaken in 35 hospitals and medical centers including 12 tertiary care hospitals and 23 secondary care hospitals in the Hubei Province, China. The detailed clinical data of 1091 hospitalized wasp sting patients were investigated. Over three-fourths (76.9%) of the cases had 10 or more stings and the in-hospital mortality of patients was 5.1%. Forty-eight patients died of organ injury following toxic reactions to the stings, whereas six died from anaphylactic shock. The in-hospital mortality in patients with >10 stings was higher than that of ≤10 stings (5.2% vs. 1.0%, p = 0.02). Acute kidney injury (AKI) was seen in 21.0% patients and most patients required blood purification therapy. Rhabdomyolysis was seen in 24.1% patients, hemolysis in 19.2% patients, liver injury in 30.1% patients, and coagulopathy in 22.5% patients. Regression analysis revealed that high creatinine level, shock, oliguria, and anemia were risk factors for death. Blood purification therapy was beneficial for patients with ≥20 stings and delayed hospital admission of patients (≥4 hours after sting). CONCLUSIONS: In China, most patients with multiple wasp stings presented with toxic reactions and multiple organ dysfunction caused by the venom rather than an anaphylactic reaction. AKI is the prominent clinical manifestation of wasp stings with toxic reaction. High creatinine levels, shock, oliguria, and anemia were risk factors for death.http://europepmc.org/articles/PMC3877022?pdf=render |
| spellingShingle | Cuihong Xie Shabei Xu Fengfei Ding Minjie Xie Jiagao Lv Jihua Yao Dengji Pan Qian Sun Chenchen Liu Tie Chen Shusheng Li Wei Wang Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases. PLoS ONE |
| title | Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases. |
| title_full | Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases. |
| title_fullStr | Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases. |
| title_full_unstemmed | Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases. |
| title_short | Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases. |
| title_sort | clinical features of severe wasp sting patients with dominantly toxic reaction analysis of 1091 cases |
| url | http://europepmc.org/articles/PMC3877022?pdf=render |
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