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Centipede Bite

Bites Centipede


Presentation

Symptoms of a centipede bite include [8]:

If the patient develops an allergic reaction to the bite, the following symptoms may also be found:

Aspiration
  • Laboratory Tests Complete blood count Serum Ag-Ab test Aspiration of pus, if present Urinalysis for proteinurea (to check for rhabdomyolysis) Imaging Studies Imaging studies are usually not required.[symptoma.com]
Skin Lesion
Flushing
  • Eye injuries should be flushed with water (irrigated) immediately.[msdmanuals.com]
  • Eye injuries should be flushed with water (irrigated) immediately. NOTE: This is the Consumer Version.[merckmanuals.com]
  • Local pruritis Headache Nausea and vomiting Occasionally vesicles or blisters Swollen lymph nodes (rare) If the patient develops an allergic reaction to the bite, the following symptoms may also be found: Tachypnea Difficulty in breathing Tachycardia Flushed[symptoma.com]
Hyperesthesia
  • .: 2 Case Study Hyperesthesia Secondary to Centipede Bite- A Case Report Huldah I.[sciencedomain.org]

Workup

Workup consists of a detailed history and physical examination.

Laboratory Tests

  • Complete blood count
  • Serum Ag-Ab test
  • Aspiration of pus, if present 
  • Urinalysis for proteinurea (to check for rhabdomyolysis)

Imaging Studies

Imaging studies are usually not required. An ECG may be conducted in patients with a past history of heart disease.

Test Results

Usually, only a detailed history is enough to make a diagnosis as patients more often than not spot the centipede in their surrounding area.

Treatment

Ice compresses/Heat packs

Covering the wound with ice compresses or heat packs, as preferred by the affected person, may be used to decrease the swelling.

Medications

Local injectable anaesthetics such as lidocaine may be administered, or common systemic analgesics such as NSAIDS (ibuprofen, naproxen, mefenamic acid, etc) may be given. Once pain has been treated, antibiotics may be given as prophylactic treatment. Prophylactic treatment by antibiotics, however, is not routinely performed in clinical practice unless there are signs of infection.

Wound examination

The wound should be carefully examined to check for any necrosis or signs of a secondary infection. It should then be treated with antiseptics and covered in gauze to heal.

Tetanus shot

A booster tetanus shot can be given.

Antihistamines

If signs and symptoms of an allergic reaction are present, antihistamines may be given.

Prognosis

The majority of bites are not life threatening to humans and present the greatest risk to children and those who develop allergic reactions [4]. Symptoms usually last fewer than 48 hours [6].

Complications

In the english medical literature, only two cases of acute coronary syndrome after centipede envenomation have been reported [7].

Complications of a centipede bite are extremely rare. They may include the following:

Etiology

A centipede bite results when a centipede stings a human being resulting in piercing of the skin. Centipedes are active and carnivorous and some species can inflict intensely painful bites, which are followed by edema, lymphangitic and necrosis [3]. Smaller centipedes usually do not puncture human skin [4].

Epidemiology

Incidence

The incidence of centipede bites is not known.

Sex

It has no prevalence in a particular sex.

Race

Centipede bites are more common in some areas of South America and Africa.

Sex distribution
Age distribution

Pathophysiology

Clinically, the wound is viewed as a cutaneous condition characterised by paired hemorrhagic marks that form a chevron shape caused by the large paired forcipules of the centipede [5].

When skin is penetrated, the centipede venom enters the system and results in a local tissue inflammatory response. The area of the bite becomes very painful, erythematous and swollen. It may also get slightly numb. Once the inflammatory cascade has abated, the swelling may gradually go down. Redness and pain fade with time as well.

If the affected person is hypersensitive, an allergic response may ensue. This may present with symptoms of an allergic reaction, as mentioned in later sections.

Prevention

A centipede bite can be easily prevented by taking precautionary measures such as wearing protective boots and gloves during gardening, camping and other such activities. Good sanitary conditions are also advised.

If the bite has occurred, systemic effects and complications may be prevented by cleaning the wound with soap and water or antiseptics and wrapping it in gauze or bandage.

Summary

Centipedes are a predominantly carnivorous taxon [1]. They belong to the phylum Arthropoda and have around 8000 known species. Their limbs, or maxillipeds, end in sharp claws and include venom glands that help the animal to kill or paralyse its prey [2].

If a centipede bites a human, its venom, which is not fatal, penetrates through the skin and causes a local tissue reaction. The reaction is characterised by sharp pain, erythema and edema.

Patient Information

Definition

A centipede bite is a wound that occurs when a medium-to-large sized centipede bites a human, such that skin is pierced.

Symptoms and Signs

Centipede bites have been reported to cause constitutional and systemic symptoms [10]. 

These include:

Signs of an allergic reaction may sometimes develop. If this occurs, visit to a nearby hospital or clinic is advised.

Treatment

Treatment includes application of ice compresses/heat packs to reduce swelling, analgesics to reduce pain and treating the wound with antiseptic cream. If an allergic reaction seems to be occurring, it is advised that you should head for the nearest clinic or hospital.

Prevention

Centipede bites can be prevented by taking precautionary measures such as wearing protective boots, coats/jackets and gloves during gardening, camping, and other such activities.

References

Article

  1. Lewis, JGE. (2007). The Biology of Centipedes. Cambridge University Press. ISBN 978-0-521-03411-1.
  2. Barnes, Robert D. (1982). Invertebrate Zoology. Philadelphia. Pa: Holt-Saunders International. pp 810-816. ISBN 0-03-056747-5.
  3. Keegan HL. In: Venomous and Poisonous Animals and Noxious Plants of the Pacific Region. Ed. Keegan HL, MacFarlane WV. Oxford, Pergamon. (1963). p196.
  4. Sean P. Bush, Bradley O. King, Robert L. Norris and Scott A. Stockwell. Centipede Envenomation. Wilderness and Environmental Medicine 2001 12 (2):93-99. 
  5. James, William D. Berger, Timothy G, et al. (2006). Andrew's Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
  6. Otten EJ. Venomous Animal Injuries. Marz JA, ed. Rosen's Emergency Medicine- Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Saunders Elsevier;2013:Chap 62.
  7. Yildiz A, Biceroglu S, Yakut N, Bilir C, Akdemir R, Akilli A. Acute Myocardial Infarction in a Young Man caused by Centipede Sting. Emerg Med J. 2006;23:e30.
  8. Steen CJ, Schwartz RA. Arthropod Bites and Stings. In: Wolff K, Goldsmith LA, Katz SI, et al, eds. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, NY: McGraw-Hill;2008:chap 210.
  9. Veraldi S, Chiaratti A, Sica L. Centipede Bite: a case report. Arch Dermatol. July 2010;146(7):807-8 
  10. Lin TJ, Yang CC, Yang GY, Ger J, Tsai WJ, Deng JF. Features of centipede bites in Taiwan. Trop Geogr Med. 1995;47:300-2 

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Last updated: 2018-06-22 10:33