A Call for sting treatment protocol: Case report of a 3 year old with massive bee sting resulting in acute kidney injury

Abstract

Acute Kidney Injury in children following bee sting envenomation is rare and survival is hinged on early recognition and prompt appropriate management. This report is aimed at raising awareness among healthcare workers, of one of the systemic effects of massive bee sting and the need to develop sting treatment protocol. A three year old preschooler was attacked by a swarm of bees, receiving over 150stings. Initial clinical features were allergic response involving the head, face and tongue for which he had first aid in a primary healthcare facility and thereafter sent home. Few hours later he developed clinical features of intravascular haemolysis, rhabdomyolysis, hypertension and acute renal failure. Laboratory findings were in keeping with clinical presentation. Despite supportive management, serum biochemistry worsened necessitating haemodialysis. Massive bee sting envenomation can cause systemic reactions and organ dysfunctions. To improve the overall clinical outcome, sting treatment protocol is advocated.

Key Words: Bee sting envenomation, acute kidney injury, sting treatment protocol, rhabdomyolysis, myoglobinuria, haemodialysis.