Acute Neurological and Respiratory Complications Induced by Wasp Stings: A Case Report.

BACKGROUND Most cases of wasp stings are mild and self-limiting; however, some cases present with life-threatening symptoms, including hemolysis, rhabdomyolysis, acute kidney injury, and liver damage. However, neurological and respiratory complications such as stroke and ARDS are rarely reported in the literature. CASE REPORT A 56-year-old woman with hypertension was stung by multiple wasps while working in a field. Laboratory tests showed a white blood cell count of 31.59×10⁹/L and a creatinine level of 270.0 μmol/L. She was treated with 3 days of methylprednisolone, 3 sessions of plasma exchange, and 8 sessions of continuous renal replacement therapy. Eleven hours after admission, her condition worsened, with blood pressure dropping to 64/44 mmHg, necessitating vasopressor support. She then progressed to acute respiratory distress syndrome and required invasive mechanical ventilation. On the eighth day, she developed mild left-sided hemiparesis. Cranial MRI/MRA confirmed acute infarction in the right insular, external capsule, and basal ganglia regions. After treatment with antiplatelet agents, lipid-lowering therapy, and rehabilitation, her neurological function improved, and she was discharged on day 26. At a 6-month follow-up, muscle strength in her left lower limb had further improved to grade 4+. CONCLUSIONS This case illustrates that wasp stings can trigger a catastrophic multi-organ dysfunction syndrome, which includes conditions such as ARDS, AKI, and even cerebral infarction. Clinicians should remain highly vigilant for rare complications following bee stings, with an emphasis on early recognition and prompt intervention.