Anaphylaxis to centipede bite

Abstract

Rationale Centipede bite commonly caused a localized pain, swelling, redness, however, serious complications are rare. There was only one reported fatality. The centipede venom is produced in a gland at the base of the forcipules and is injected when they are driven into tissues. In some species, the venom contains 5-hydroxytryptamine or cytolysin. There is an occurrence of histamine release by these venoms so that other important components are present and require further study. In this report we describe a case of centipede bite causing an anaphylactic reaction in a 23-year–old man. He had been bitten on his left little finger by a twenty-centimeter-long centipede. Within 5 minutes, he developed face swelling and generalized urticarial rash. Ten minutes later, he felt discomfort in his chest, slowly became unresponsive and was delivered to the emergency room where he was found hypotensive with systolic blood pressure of 50 mmHg and unmeasurable diastolic blood pressure. Standard treatment with epinephrine, intravenous volume expansion and iv antihistamine were started. After 400 ml of intravenous normal saline infusion, he gained conscious and became normotensive. Systemic corticosteroid was given and the patient was admitted to ward. Laboratory investigation revealed only leucocytosis with lymphocyte predominate. He was observed for 1 day until all clinical signs were improved then discharged home. Unfortunately he did not come back to follow up. Conclusion Anaphylaxis from centipede bite can occurred and should be awared. As far as we know, this is the first case report for centipede anaphylaxis.