Caterpillar envenomations: a prospective study of 112 cases
Everson, G.W.; Chapin, J.B.; Normann, S.A.
Veterinary and Human Toxicology 32(2): 114-119
1990
ISSN/ISBN: 0145-6296 PMID: 2327053 Document Number: 358408
A 1-year prospective study was conducted to identify epidemiological factors associated with caterpillar "envenomations" in Louisiana. Of 117 persons calling the Louisiana Regional Poison Center who reported being stung by caterpillars in 1987, 112 cases were fully documented and included in the study. Identification of the caterpillars involved was accomplished in 68% of the cases. Six caterpillar species were identified, 4 of which (Hemileuca maia (37/76), Megalopyge opercularis/Lagoa crispata (17/76), Sibine stimulea (12/76) and Automeris io (8/76)) were properly implicated in envenomations. (In addition, one individual each of Malacosoma disstria and Manduca sp. were purported to cause stings). Clinical effects most commonly reported were local pain, erythema and swelling in 96%, 89% and 72% of patients, respectively. Atypical responses including muscle spasms, paresthesia and radiating pain to an extremity were noted in 26% of patients. 16% of patients had a history of allergy, but no patient in this subgroup exhibited a "hive-like" dermatologic or anaphylactic allergic response. No positive correlation could be drawn between allergy history and extent of clinical effect following envenomation. Mild to moderate local response following envenomation was typical. However, 61% of patients evaluated experienced mild to moderate effects at least 24 h post-envenomation.