Isolated Acute Liver Injury Following Mass Envenomation by Wasps

Acute liver injury from wasp venom exposure has been reported in the literature, most often in the context of anaphylaxis and multiorgan injury. We present a case of isolated liver injury, a rare presentation, in a healthy 26-year-old man stung by more than 40 wasps. We observed a delayed presentation with conjugated hyperbilirubinemia, significantly raised transaminases, and mild coagulopathy, in the absence of other organ involvement. Complete normalization of liver enzymes was seen 61 days following presentation. Clinicians encountering patients with liver injury in the context of wasp stings should consider wasp venom-associated hepatitis as a possible cause.