- Wasp bites are a common encounter in Sri Lanka.
- Although there are several benefits of wasps, the sting may lead to serious health issues including local reactions and life threatening complications. For example, anaphylaxis and arterial thrombosis.
- Vascular thrombosis or brachial artery thrombosis, however, is a rare complication and only a few cases have been reported in literature.
This article describes the case of a 65-year-old previously healthy male patient diagnosed with brachial artery thrombosis caused by multiple wasp bites. The patient from Anuradhapura, north-central part of Sri Lanka, presented to the hospital with multiple wasp bites over his head and upper trunk. He had mild local pain at the site of the sting, however, was hemodynamically stable.
The patient developed angioedema of the lips and tongue. Doctors treated him with intramuscular adrenaline at the emergency treatment unit. Doctors transferred him to the general medical ward for observation, later. 8 hours after the sting, the patient developed severe pain on the left upper limb. Examination showed that the limb was cold to touch. He was started on feeble radial and brachial artery pulses. There was no detection of finger saturation on air. Doctors, therefore, referred the patient for a vascular surgical opinion. And started him on IV heparin infusion. Doctors started him on IV heparin infusion. For further evaluation, he was advised a CT angiogram. The angiogram showed long-segment brachial artery thrombosis from midhumerus level on the left side.
The patient underwent a thrombectomy on the same day and a fasciotomy the next day to salvage the limb.
The rule out the cause of this arterial thrombosis, doctors advised other laboratory tests. The tests included, complete blood count, liver and renal functions, fasting blood sugar, lipid profile, ECG, 2D echo, and clotting profile with thrombophilia screening. All test results were within normal range.
Doctors concluded that the brachial artery thrombosis was because of the wasp sting, with absence of other risk factors.
References
Brachial Artery Thrombosis following Multiple Wasp Bites https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920701/
