{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:35:15Z","timestamp":1780104915404,"version":"3.54.0"},"reference-count":15,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T00:00:00Z","timestamp":1585785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008108","name":"Taipei Tzu Chi Hospital","doi-asserted-by":"publisher","award":["(TCRD-TPE-109-02, TCRD-TPE-109-03)."],"award-info":[{"award-number":["(TCRD-TPE-109-02, TCRD-TPE-109-03)."]}],"id":[{"id":"10.13039\/501100008108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Insects"],"abstract":"<jats:p>Envenoming syndrome is a systemic reaction induced by inoculation of large volumes of Hymenoptera venom. The clinical manifestations range from skin allergic reactions to multiple organ failure. Vespid venom-induced toxic reactions and anaphylaxis are the most common lethal mechanism of death, involving acute respiratory failure, acute liver failure, rhabdomyolysis, acute kidney injury, and severe coagulopathy. Multiple organ failure as a consequence of severe venom toxicity is a rare but dangerous complication in victims. Delay of intervention to correct vespid venom-induced toxic reactions may cause catastrophic complications. Here, we describe a case presenting a rare vespid venom-induced multiple organ failure with systemic coagulopathy after massive Vespa attack.<\/jats:p>","DOI":"10.3390\/insects11040219","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T10:33:58Z","timestamp":1585823638000},"page":"219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["An Envenoming Syndrome from Massive Vespa Stings Induces Multiple Organ Failure"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6370-7068","authenticated-orcid":false,"given":"Tse-Hao","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Ting","family":"Liao","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan"},{"name":"Chinese Medicine Department, Show Chwan Memorial Hospital, Changhua 500, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 231, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 231, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8773-1847","authenticated-orcid":false,"given":"Meng-Yu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 231, Taiwan"},{"name":"Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.wem.2016.05.005","article-title":"Significant Traumatic Intracranial Hemorrhage in the Setting of Massive Bee Venom-Induced Coagulopathy: A Case Report","volume":"27","author":"Stack","year":"2016","journal-title":"Wilderness Environ. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.wem.2017.05.007","article-title":"Two Cases of Acute Kidney Injury Due to Multiple Wasp Stings","volume":"28","author":"Vikrant","year":"2017","journal-title":"Wilderness Environ. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13049-016-0344-y","article-title":"Pre-Hospital Treatment of Bee and Wasp Induced Anaphylactic Reactions: A Retrospective Study","volume":"25","author":"Oropeza","year":"2017","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s12264-016-0024-y","article-title":"Melittin, the Major Pain-Producing Substance of Bee Venom","volume":"32","author":"Chen","year":"2016","journal-title":"Neurosci. Bull."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s12024-015-9737-x","article-title":"Deaths from bee stings: A report of three cases from Pretoria, South Africa","volume":"12","author":"Morris","year":"2016","journal-title":"Forensic. Sci. Med. Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1053\/j.ctsap.2006.10.002","article-title":"Hymenoptera stings","volume":"21","author":"Fitzgerald","year":"2006","journal-title":"Clin. Tech. Small Anim. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1542\/peds.111.S3.1601","article-title":"Anaphylaxis and Emergency Treatment","volume":"111","author":"Sampson","year":"2003","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1093\/ndt\/gfp583","article-title":"Swarming hornet attacks: Shock and acute kidney injury\u2013a large case series from Vietnam","volume":"25","author":"Xuan","year":"2010","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Tahura, S. (2018). Acute Kidney Injury in Children Following Multiple Wasp Stings and its Immediate Outcome. Adv. Clin. Toxicol., 3.","DOI":"10.23880\/ACT-16000124"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1590\/0037-8682-0341-2017","article-title":"Multiple bee stings, multiple organs involved: A case report","volume":"51","author":"Toledo","year":"2018","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s12098-007-0208-6","article-title":"Multiple organ dysfunction syndrome following single wasp sting","volume":"74","author":"Sharmila","year":"2008","journal-title":"Indian J. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1080\/15563650701664871","article-title":"Cutaneous hemorrhage or necrosis findings after Vespa mandarinia (wasp) stings may predict the occurrence of multiple organ injury: A case report and review of literature","volume":"45","author":"Yanagawa","year":"2007","journal-title":"Clin. Toxicol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1111\/all.13077","article-title":"Allergen immunotherapy for insect venom allergy: A systematic review and meta-analysis","volume":"72","author":"Dhami","year":"2017","journal-title":"Allergy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1111\/ddg.13670","article-title":"Honeybee and wasp venom allergy: Sensitization and immunotherapy","volume":"16","author":"Bayerl","year":"2018","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/all.13262","article-title":"EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy","volume":"73","author":"Sturm","year":"2018","journal-title":"Allergy"}],"container-title":["Insects"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4450\/11\/4\/219\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:14:34Z","timestamp":1760174074000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4450\/11\/4\/219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,2]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,4]]}},"alternative-id":["insects11040219"],"URL":"https:\/\/doi.org\/10.3390\/insects11040219","relation":{},"ISSN":["2075-4450"],"issn-type":[{"value":"2075-4450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,2]]}}}