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Massive Vespa basalis stings induce an envenoming syndrome

  • Yao-Chen Wang
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
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  • Chan-Yang Hsu
    Affiliations
    Division of Cardiovascular Surgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan

    Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Tzu Chi University, Hualien, Taiwan
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  • Yu-Long Chen
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
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  • Po-Chen Lin
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
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  • Meng-Yu Wu
    Correspondence
    Corresponding author at: Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
    Affiliations
    Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan

    Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
    Search for articles by this author
Published:November 23, 2020DOI:https://doi.org/10.1016/j.ajem.2020.11.053

      Abstract

      Envenoming syndrome induced by massive Vespa basalis stings is a critical condition. Severe systemic reaction may present with hemolytic activity and rhabdomyolysis, leading diffuse alveolar hemorrhage, adult respiratory distress syndrome, coagulopathy, and multiple organs failure. In severe envenoming syndrome population, extracorporeal membrane oxygenation (ECMO) may be considered for unstable hemodynamic status. However, few studies reported ECMO in venom-induced disseminated intravascular coagulation patients. Here, we provide a case presented with pulmonary hemorrhage due to multiple Vespa basalis stings tried to rescue by veno-arterial extracorporeal membrane oxygenation. We also highlight that early recognition of venom-induced disseminated intravascular coagulation by checking coagulation profile in high risk patients may prevent from poor outcome.

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