Stings by the Asian giant hornet can result in a range of toxic effects, including acute interstitial nephritis.
Patient selection: status post stings by the Asian giant hornet (Vespa mandarinia)
Mechanism: injection of complex toxin
Risk factors:
(1) multiple stings
(2) delay in management
(3) delayed hypersensitivity or anaphylaxis
Clinical features:
(1) deterioration in renal function
(2) acute renal failure
(3) variable rhabdomyolysis
(4) multi-organ failure
A renal biopsy shows edema and an interstitial infiltrate with eosinophils and lymphocytes.
