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Encephalomyeloradiculopathy associated with wasp sting

Although stings from wasps can cause severe allergic reactions, including anaphylaxis, neurological complications of wasp stings are rare. There are, however, various interesting case reports of acute myelitis, acute encephalitis, encephaloradiculoneuritis, optic neuropathy,1 cerebral infarction,2 and acute inflammatory polyradiculopathy.3 We report here the case of a young man who developed encephalomyeloradiculopathy after being stung by a wasp.

An 18 year old man was referred to Ramathibodi Hospital with impaired consciousness and quadriplegia. He had been stung by a wasp 16 days previously on the right cheek and had mild swelling and tenderness over this area. On the following day, he suffered from headache, fever, and nausea and was admitted to a regional hospital. Three days later, he was drowsy and had urinary retention. Then he developed a generalised tonic–clonic seizure lasting two to three minutes. He was intubated and referred to us.

At Ramathibodi Hospital, he was comatose, quadriplegic, and areflexic. A lumbar puncture was done. The CSF pressure was 360 mm H2O and fluid analysis showed mononuclear cells (9/mm3), a protein concentration of 160 mg/dl, and CSF/blood sugar concentrations of 4.38/13.38 mmol/l. CSF and …