Rhabdomyolysis Following Multiple Wasp Stings: A Case Report

Hymenoptera stings can result in severe systemic reactions, including rhabdomyolysis—a condition characterized by skeletal muscle breakdown. This report describes a case of rhabdomyolysis following multiple wasp stings and underscores the critical role of prompt treatment.
A 63-year-old farmer was admitted to the Emergency Department following multiple wasp stings on the head, face, trunk, and upper limbs. He presented with pain at the sting sites and gastrointestinal symptoms like diarrhoea, but no signs of systemic allergic reactions or previous significant health issues. Initial tests revealed mild liver enzyme elevation, with normal kidney function. By Day 3, the patient exhibited muscle pain and significantly elevated creatine phosphokinase (CK) levels (12,597 U/L), confirming rhabdomyolysis. Aggressive fluid resuscitation, including forced alkaline diuresis, was administered. The patient remained hemodynamically stable, with normal renal function throughout his hospital stay. CPK and liver enzyme levels gradually normalized, and he was dscharged after 5 days with advice for continued hydration. Follow-up confirmed recovery without residual complications.
Rhabdomyolysis should be considered in patients with muscle pain following wasp stings. Early diagnosis and aggressive fluid therapy are crucial in preventing severe complications, such as acute kidney injury. Further research is needed to elucidate the mechanisms of wasp venom-induced rhabdomyolysis and refine treatment strategies.