We reported a case of multiple organ dysfunction syndrome (MODS) following about 300 wasp stings. The diagnosis was based on autopsy findings of acute pulmonary edema, acute kidney injury, hepatic and cardiac dysfunction, and cerebral edema. MODS is a life-threatening complication, and should be considered a possibility after multiple wasp stings. Our autopsy helped to establish the cause of unexpected death due to wasp stings and to elucidate a possible mechanism of MODS.
Adult ; Animals ; Fatal Outcome ; Female ; Humans ; Insect Bites and Stings ; complications ; Multiple Organ Failure ; etiology ; Wasps

Aged ; Anaphylaxis ; etiology ; Animals ; Female ; Humans ; Insect Bites and Stings ; complications ; Myocardial Infarction ; etiology ; Wasps

Shark attacks are rare unique pathological processes. Some of them represent devastating injuries with a high morbidity and significant mortality. Related published articles are limited. The increased human interaction within the environment of sharks is the cause of rising incidence of such attacks. This study reported a case of level 4 shark injuries (shark-induced trauma scale) in a 33-year-old male patient, who presented with an extensive injury of the right lower limb with the characteristic features of shark bite. At admission the patient was in a state of shock with profuse bleeding that was controlled by tourniquet. The patient was resuscitated according to the advanced trauma life support. Clinical examination showed hard signs of vascular injury with absent pedal pulse, associated neurological deficits and severance at the knee joint. Prompt vascular intervention after resuscitation was performed to manage the major vascular injuries, together with proper washout and debridement of all the necrotic tissues under strong antibiotic coverage to prevent infection. After that, the patient underwent sequenced plastic, orthopedic, and neurological interventions. Strict follow-up was conducted, which showed that the patient was saved and achieved a functioning limb. This study aims to highlight the management of level 4 shark injuries, which are considered serious and challenging with a high fatality rate and a great risk of amputation due to the associated major vascular injuries. Immediate well organized management plan is crucial. Prompt resuscitation and surgical intervention by a highly-skilled medical team are required to improve the chance of patient survival and limb salvage.
Adult ; Animals ; Bites and Stings/complications* ; Humans ; Limb Salvage ; Male ; Retrospective Studies ; Sharks ; Vascular System Injuries/surgery*

OBJECTIVETo understand the clinical characteristics of Lyme disease in children.

METHODSCase records of 30 children with Lyme disease who were admitted to the pediatric department of Forest Hospital, Inner Mongolia from May 1995 to Oct. 2000, were reviewed. Twenty-one cases were male and 9 were female. Their age ranged from 2 to 14 years. The possible factors associated with the onset, incubation period, clinical manifestations of the organ systems and response to treatment were analyzed.

RESULTSEach of the 30 cases had a history of tick bite for one time or more. The incubation period was 1 to 14 days. All of them were hospitalized for typical erythema migrans. Among the 30 cases, 21 (70%) showed symptoms of acute upper respiratory tract infection; 4 (13%) showed circulatory system symptom and manifestations of myocardial lesion; 3 (10%) had joint pain; 1 case (3%) had eye symptom and another case (3%) had nervous system symptoms, such as headache, vomiting, drowsiness, neck stiffness and so on. EEG and spinal fluid test showed some abnormal results. All the 30 cases were positive for IgG antibody to Lyme spirochetes with titers higher than 1:128. Penicillin or cefazolin was effective in treatment of the patients.

CONCLUSIONThe incubation period of the disease observed among this series of patients was 1-14 d. Lyme disease in this group of patients involved multiple organ systems while erythema migrans and arthralgia were the most frequently seen manifestations. Most of the patients had a favorable outcome with no sequelae.

Adolescent ; Animals ; Bites and Stings ; complications ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin G ; blood ; Lyme Disease ; diagnosis ; etiology ; immunology ; Male ; Ticks

Hypersensitivity to mosquito bites (HMB) is a rare disease characterized by intense skin reactions such as bulla and necrotic ulcerations at bite sites, accompanied by general symptoms such as high-grade fever and malaise occurred after mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer (NK) cell leukemia/lymphoma. We describe here a Korean child who presented with 3-yr history of HMB without natural killer cell lymphocytosis. He has been ill for 6 yr with HMB. Close observation and examination for the development of lymphoproliferative status or hematologic malignant disorders is needed.
Child ; Epstein-Barr Virus Infections/complications ; Humans ; Hypersensitivity/*diagnosis/etiology ; Insect Bites and Stings/*diagnosis/pathology ; Killer Cells, Natural/immunology ; Lymphocytosis/complications/pathology ; Male ; Republic of Korea ; Skin/pathology

Abscess ; drug therapy ; etiology ; Animals ; Bites and Stings ; complications ; Cats ; Female ; Humans ; Middle Aged ; Pasteurella multocida ; isolation & purification ; Skin Diseases, Bacterial ; drug therapy ; etiology

Adolescent ; Animals ; Bees ; Child ; Child, Preschool ; Female ; Hemodiafiltration ; adverse effects ; methods ; Humans ; Infant ; Insect Bites and Stings ; complications ; Male ; Multiple Organ Failure ; therapy

Acute Coronary Syndrome ; etiology ; Administration, Intravenous ; Anaphylaxis ; drug therapy ; Animals ; Bees ; Epinephrine ; administration & dosage ; Humans ; Insect Bites and Stings ; complications ; Male ; Middle Aged

Hypersensitivity to mosquito bites (HMB) is a disorder characterized by a necrotic skin reaction and generalized symptoms subsequent to mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer cell leukemia/lymphoma. We describe here a Korean child who had HMB associated with chronic EBV infection and natural killer cell lymphocytosis. A 5-yr-old boy was suffered from necrotic skin lesions on the right ear lobe. Type A EB virus was detected from hlood cells and bone marrow biospy recognized hemophagocyrosis.
Animals ; Child, Preschool ; Culicidae/*immunology ; Epstein-Barr Virus Infections/complications/*diagnosis ; Herpesvirus 4, Human/genetics/isolation & purification ; Humans ; Hypersensitivity/complications/*diagnosis ; Insect Bites and Stings/complications/*immunology ; Killer Cells, Natural/immunology/*pathology ; Lymphocytosis/complications/*diagnosis ; Male ; Polymerase Chain Reaction

Hypersensitivity to mosquito bites (HMB) is characterized by intense skin reactions at bite sites. The pathogenesis of HMB might be related to clonal lymphoproliferation of Epstein-Barr virus DNA-positive natural killer (NK) cells. We report the first case of HMB possibly associated with NK cell-derived large granular lymphocyte (NK-LGL) lymphocytosis in Korea.
Adult ; Animals ; Base Sequence ; *Culicidae ; Epstein-Barr Virus Infections/*complications/diagnosis ; Humans ; Hypersensitivity/*etiology/virology ; Insect Bites and Stings/*complications/immunology ; Killer Cells, Natural/*immunology/pathology ; Korea ; Lymphocytosis/*complications/pathology ; Male ; Molecular Sequence Data ; Polymerase Chain Reaction ; Prognosis ; Risk Assessment