Centipede Bite Research Articles

Systemic anaphylaxis following centipede envenomation: A case report and review of literature

ABSTRACT Centipede envenomation is usually not life-threatening. They usually present with local symptoms of swelling and pain. Centipede venoms contain large amounts of allergenic proteins that can pose a risk of allergic complications following the bite. Here, we report a rare but important case of systemic anaphylaxis in the form of abdominal pain immediately following a centipede bite that subsided after adrenaline administration. Knowledge of this systemic anaphylaxis is essential for timely management of centipede envenomation.

Thrombocytopenia Developing After Centipede Bite

Thrombocytopenia Developing After Centipede Bite

Bioactive Peptides and Proteins from Centipede Venoms.

Venoms are a complex cocktail of biologically active molecules, including peptides, proteins, polyamide, and enzymes widely produced by venomous organisms. Through long-term evolution, venomous animals have evolved highly specific and diversified peptides and proteins targeting key physiological elements, including the nervous, blood, and muscular systems. Centipedes are typical venomous arthropods that rely on their toxins primarily for predation and defense. Although centipede bites are frequently reported, the composition and effect of centipede venoms are far from known. With the development of molecular biology and structural biology, the research on centipede venoms, especially peptides and proteins, has been deepened. Therefore, we summarize partial progress on the exploration of the bioactive peptides and proteins in centipede venoms and their potential value in pharmacological research and new drug development.

Von Willebrand disease: a report of 3 cases diagnosed with different contexts and review of literature

Background: Von Willebrand disease is the most common human inherited bleeding disorder. A major challenge for affected patients is achieving an accurate and timely diagnosis. We reported 3 cases of von Willebrand disease diagnosed with different contexts. Case report: Case 1: male, 2.5 months old, whose grandfather and aunt have a bleeding disorder. Hospitalized with purpura and ecchymosis. Was diagnosed with VWD type 1 and monitored at home when bleeding. Case 2: male, 13 years old, diagnosed with Hemophilia A from 2 years old. Unresponsive to treatment, bleeding of the skin and mucosa. Diagnosis of VWD type 1. Treating with cryoprecipitate and oral minirin, the frequency of hospitalization is reduced and well-response. Case 3: female, 9 years old, hospitalized because of a centipede bite. After 4 days, the skin was bleeding with purpura and ecchymosis, and the laboratory showed prolonged APTT and decreased VWF antigen. Diagnosis of acquired VWD after a centipede bite. After 1 month of follow-up, the child did not bleed, and the test returned to normal. Conclusion: The cases described above help to generalize the different diagnostic contexts. The suggestion of VWD is raised when there is a mismatch between clinical and general coagulation tests. A definitive diagnosis of VWD requires a VWF test. Key words: von Willebrand disease, Bleeding disorder, von Willebrand factor

Mortality caused by venomous animals in Venezuela (2000-2009): A new epidemiological pattern

IntroducciónLos accidentes causados por animales venenosos ocurren con mucha frecuencia en comunidades pobres con acceso limitado a los servicios de salud. Se les consideran enfermedades desatendidas y son una de las causas importantes de morbimortalidad en varias naciones del mundo, incluida Venezuela.ObjetivoEvaluar la mortalidad por contacto traumático con animales venenosos (serie X20-X29) en Venezuela en el periodo de 2000 a 2009.Materiales y métodosLos datos se obtuvieron de los anuarios de mortalidad del Ministerio de Salud.ResultadosSe registraron 759 decesos, la mayoría de ellos en el 2009. La primera causa fue la mordedura de serpientes (n=323; 42,6%), seguida por la picadura de himenópteros (n=170; 22,4%), la mordedura de centípedos (n=106; 14,0%) y la picadura de escorpiones (n=76; 10,0%). La mediana de la tasa de mortalidad general para el periodo fue de 0,285 fallecidos por 100.000 habitantes, en tanto que, por grupo específico, fue de 0,120 para ofidios, de 0,065 para himenópteros, de 0,035 para centípedos y de 0,025 para escorpiones.ConclusiónAl comparar estos datos con los antecedentes históricos, se evidenció la modificación del patrón de mortalidad en el país caracterizada por un aumento significativo de los decesos por centípedos, tercera causa de muerte, lo que reubica la picadura de escorpiones como la cuarta causa de mortalidad.

Patients with centipede bites presenting to a university hospital in Bangkok: a 10-year retrospective study

Introduction Centipede envenomation occurs commonly in tropical and subtropical countries. In most cases, centipede envenomation causes benign clinical manifestations. Serious complications are reported occasionally. Clinical studies regarding centipede envenomation are limited to case reports and case series. This study aimed to determine the prevalence and clinical characteristics of centipede bites in Bangkok, Thailand. Methods This was a retrospective medical record review study. We included patients who were clearly envenomated by a centipede presenting to the emergency department of a tertiary university hospital in Bangkok from January 1, 2006, to December 31, 2015. Data were collected on demographics, details of the exposure, signs, symptoms, treatment, and complications of envenomation. Results A total of 245 cases were included. The prevalence of centipede bite was 0.0367%. The majority were female (56.7%). The median age was 34.6 years (range: 1 month to 90 years). The number of envenomations was highest from October through December. Feet (38.3%) and hands (19.1%) were the parts of the body most often envenomated. Local effects were common with 99.5% of patients having localized pain and 87% having local swelling at the bite site. In terms of systemic effects, urticarial rash (5.7%) and fever (4.1%) were most frequently observed. Twelve cases (5%) had clinical pictures compatible with anaphylaxis. For pain management, all patients who had pain received analgesic drugs, while 29.7% were injected with local anesthesia. Antibiotics, antihistamines, and steroids were prescribed in 53.9%, 20.4%, and 10.2% of cases, respectively. No deaths occurred in this study. Conclusions Even though the location of our hospital is in a metropolitan city in Thailand, there were centipede bites every month, especially during the last three months of each year. Nearly all patients had local effects. In contrast, serious complications such as anaphylaxis and systemic infection only occurred occasionally.

Isolation and characterization of the major centipede allergen Sco m 5 from Scolopendra subspinipes mutilans

BackgroundAllergic reactions have been observed following both direct centipede bites and the clinical use of centipede-containing medicines, such as traditional Chinese medicines utilizing Scolopendra subspinipes mutilans; however, no natural centipede allergen has yet been characterized. MethodsAn allergen was purified from S. s. mutilans venom using Superdex 75 gel filtration and RESOURCE S ion chromatography, and its primary structure was determined via a combination of LC-MS-MS, MALDI-TOF/TOF and protein sequencing techniques. Its potential allergenicity was evaluated by immunoblotting, ELISAs, skin prick tests (SPTs) and mast cell activation assays. ResultsA novel allergen Sco m 5 (210 amino acids long) was successfully purified from crude S. s. mutilans venom. Sco m 5 could promote the degranulation of a human mast cell line, HMC-1. Among centipede-allergic patients, Sco m 5 showed an 83.3% IgE-binding frequency and a 66.7% positive reaction frequency, as detected by immunoblotting and SPTs, respectively. Sco m 5 IgE-binding frequencies of common Chinese population was found to be 9%–16%. Sera positive for Sco m 5 IgE-binding was cross-reactive against venom from the wasp Vespa mandaeinia. ConclusionsThe present study isolated and characterized a novel allergen termed as Sco m 5 from the centipede S. s. mutilans. The use of Sco m 5 to identify centipede-allergic individuals could be important, given the high potential allergenicity of Sco m 5 among the general Chinese population, along with the likely possibility of cross-reactivity against wasp venom among centipede-allergic patients.

Complex regional pain syndrome following a centipede bite: a case report

Context: Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain condition associated with autonomic features. To date, the development of CRPS following centipede bite has not been reported. We report a case of CRPS likely secondary to a centipede bite.Case details: A 31-year-old female was bitten by a centipede on the right 2nd toe. She was initially treated with analgesics, and two weeks later developed severe pain, allodynia, pruritus, and edema of the right foot, with hyperpigmentation over the affected toe. The X-ray, ultrasound, electromyography, nerve conduction velocity studies of the foot, blood chemistries, and erythrocyte sedimentation rate showed no abnormalities. The patient was diagnosed with CRPS type 1 by fulfilling the Budapest criteria. She was treated with gabapentin, amitriptyline, desloratadine, and fluoxetine, along with physical rehabilitation. Clinical symptoms gradually improved, and resolved at approximately 9 months with persistent hyperpigmentation.Discussion: Centipede bite may be an eliciting event for CRPS. It is unknown whether direct bite trauma or envenomation was the primary etiology in this case. Awareness of this condition is important for early diagnosis and appropriate management.

Centipede envenomation: Clinical importance and the underlying molecular mechanisms

Centipede bites are usually characterized by mildly to moderately painful encounters with humans, however, they are relatively infrequent. The vast majority of centipede envenomations do not cause severe symptoms and only in very rare cases more serious symptoms such as myocardial ischemia and infarction, hematuria, hemoglobinuria, rhabdomyolysis, hemorrhage, pruritus, eosinophilic cellulitis, as well as anaphylaxis are observed. More prevalent are symptoms including pain, paresthesia, lethargy, localized necrosis, headache, dizziness and nausea. The numerous symptoms and complications elicited by these envenomations indicate that centipede venom possesses an arsenal of chemical components with functional diversity. Centipede venom is a rich and complex natural source of bioactive proteins, peptides and other small molecules that aid in predation or defense. The venom can induce myotoxic, cardiotoxic, neurotoxic and other toxic effects. The constituents target different cellular processes and pathways which in turn trigger a cascade of physiological reactions in the victim. The venom components are potent and selective on peripheral targets; thus, they are valuable in studying the molecular basis of these envenomation symptoms and complications. This review highlights the clinical importance of centipede envenomation and the recent discoveries on the underlying molecular mechanisms of the resulting symptoms which is crucial in therapy.

Clinico-epidemiology of arthropod stings and bites in primary hospitals of North Western province of Sri Lanka

Objective: Arthropod stinging and bites are common environmental hazards in Sri Lanka. However, their medical importance has not been fully evaluated yet. This study aims to study the burden, epidemiology, and outcome of stings and bites in primary hospitals in the Kurunegala district in North Western Province (NWP) of Sri Lanka.Methodology: The study was conducted one year from 25th May 2013 to 25th May 2014. Details of all stings and bites admissions and their outcomes were retrospectively extracted from hospital records in all 44 primary hospitals in the district.Results: There were 623 stings and bites with population incidence of 38/100,000 (95% CI 27–52). There were no deaths. Median age was 38 years (IQR: 19–53 years), and 351 (56%) were males. Most of stings and bites (75%) occurred in the daytime. Median time to hospital arrival was 55 minutes (IQR: 30 min to 2 h). The offending arthropods had been identified in 557 (89%) cases, of them, 357 (57%) were Hymenoptera (hornet and bees), 99 centipedes, 61 spiders and 40 scorpions. Local pain occurred in 346 (56%) cases – centipede 69 (70%), Scorpion 24 (60%), spider 36 (59%), Hymenoptera 187 (52%) and unidentified 30 (45%). Hymenoptera stings and spider bites occurred between 06 am to 12 noon, and scorpion stings and centipede bites mostly occurred between 06 pm to 12 midnight. Mild, moderate to severe anaphylaxis reactions occurred in 173 (28%) patients including 110 Hymenoptera stings – mild 39, moderate 62 and severe 9. From primary hospitals, 53(9%) cases had been transferred to tertiary care units for further management. Of them, 41 cases were Hymenoptera stings and 24 (58%) of them had mild, moderate to severe anaphylaxis. In the entire group, 27% severe cases received adrenaline.Conclusions: The primary hospitals in NW province of Sri Lanka manage large numbers of arthropod stings and bites. These include Hymenoptera (hornet and bee), centipedes, spiders, and scorpions. Pain, swellings and anaphylactic reactions were the most common adverse effects.

Clinical consequences of centipede bite: Is it neurotoxic?

Clinical consequences of centipede bite: Is it neurotoxic?

Hyperesthesia Secondary to Centipede Bite- A Case Report

Background: Centipede bite is a major public health problem among rural communities of Nigeria. This can be attributed to thick bushes around residential homes and humid weather peculiar to these regions, which favor the survival of this group of arthropods. However, presentations of cases to hospitals are rare. Objective: To report a case of hyperesthesia secondary to centipede bite in Nigeria. Methods: The case note of the patient was retrieved and relevant data were extracted and summarized. Results: An 80 year old retired civil servant, now a farmer, presented to the outpatient clinic, with a history of severe pains following centipede bite two weeks prior to presentation. Pains were so severe that he could not stand without support. He was later diagnosed with avascular Necrosis of right head of femur and presently on physiotherapy regimen.

Scolopendra bites: a report of two cases and review of the literature

Centipedes are arthropods belonging to the class Chilopoda. Approximately 3000 species have been described. Centipedes are found more commonly in tropical and subtropical countries. Centipedes possess venomous fangs. The Scolopendra represent the best-known genus of centipede. We describe two cases of severe skin reactions caused by Scolopendra subspinipes bites. Both patients were bitten on the hand. The clinical picture was characterized by severe erythematous edema. In addition, one patient presented with a blister. Both patients complained of severe pain. Laboratory examinations showed leukocytosis and an increase in erythrocyte sedimentation rate (ESR). Complete remission was achieved within twoweeks by means of paracetamol and oral prednisone. Western dermatologists should be aware of the possibility of severe skin reactions caused by centipede bites.

A case of anaphylactic shock after centipede bite, and characteristics of 16 patients with centipede bites at Himeshima National Health Insurance Clinic in Himeshima village, Oita, Japan, between 2010 and 2013

A case of anaphylactic shock after centipede bite, and characteristics of 16 patients with centipede bites at Himeshima National Health Insurance Clinic in Himeshima village, Oita, Japan, between 2010 and 2013

Shock and Pain: Centipede Bite Causing Reversible Myocardial Injury

INTRODUCTION: Centipedes are multisegmeted arthropods with a single pair of legs per segment and one pair of antennae .Centipede stings occur in the warmer climates throughout the world. The species of medical importance is Scolopendra Sp which has been described as the longest and the most aggressive tropical centipede. Centipede stings often occur as the victim is putting on clothes or while in bed.CASE PRESENTATION: A 19 yr old female arrived in our tertiary care emergency room at 5:30am after being treated at a local hospital for an unknown insect bite on her right arm 6 hrs prior while asleep.She had complaints of vomiting,dyspnea and local pain.She received antihistamines,steroids,epinephrine and analgesics for anaphylactic shock and pain prior to arrival.Her presenting vitals were a heart rate of 145 beats per minute, BP 60/40 mmHg ,respiratory rate of 35/min and oxygen saturation of 85% on room air. She had bilateral crackles and her hemoglobin,WBC count,electrolytes and PT,INR were normal. EKG revealed ST depression in V3,V4,V5,V6 leads (>2mm).Chest radiograph showed pulmonary edema and echocardiogram showed global hypokinesia of the left ventricle with EF of 40%,while troponin-t(2.98)was slightly elevated . Treatment was initiated with digoxin,carnitine and dobutamine infusion to support her cardiac output and furosemide was given for pulmonary edema along with non-invasive ventilation.She improved with therapy and a repeat echocardiogram two days later showed EF of 62% with normal LV function.Subsequent history and bystander observation confirmed the visual appearance of the insect to be a centipede.DISCUSSION: Gomes et al (1)used animal models to demonstrate significant cardiovascular effects of Scolopendra venom, mediated by histamine and a cardiodepressant factor designated as Toxin-S. Most authorities recognize the cardiodepressant Toxin-S to be the lethal factor (predatory), and the histamine/serotonin components to be pain mediators (defensive)(2). Systemic symptoms due to centipede bite may include anxiety, fever, dizziness, palpitations, and nausea. Extensive myonecrosis with subsequent compartment syndrome, rhabdomyolysis, and acute renal failure has been seen after a centipede bite.Japanese Scolopendra species have been reported to cause psychological disturbances and Korsakoff syndrome. A recent study suggests possible myocardial ischemia after a nonfatal centipede sting as a mechanism that could lead to death(3)CONCLUSIONS: There have been only a few cases of centipede envenomation causing myocardial ischaemia reported. Our case was notable due to the acute presentation of pulmonary edema with cardiac injury with raised cardiac enzyme levels. This complication should be considered when treating such patients, and appropriate diagnostic studies should be obtained.1) Gomes A, Datta A, Sarangi B, Kar PK, Lahiri SC. Occurrence of histamine and histamine release by centipede venom. Indian J Med Res. 1982;76:888.2) Stankiewicz M, Hamon A, Benkhalifa R, et al. Effects of a centipede venom fraction on insect nervous system, a native Xenopus oocyte receptor and on an expressed Drosophila muscarinic receptor. Toxicon.1999;37:1431-1445.3) Ozsarac M, Karcioglu O, Ayrik C, Somuncu F, Gumrukcu S. Acute coronary ischemia following centipede envenomation: Case report and review of the literature. Wilderness Environ Med. 2004;15:109-12DISCLOSURE: The following authors have nothing to disclose: Munta Kartik, Sai Praveen Haranath, Rahul Amte, Palepu GopalNo Product/Research Disclosure InformationApollo Hospitals, Department of Critical Care Medicine, Jubilee Hills, Hyderabad, India. Language: en

Characteristics of patients with bee sting, centipede bite, or viper bite treated at Ashikaga Red Cross Hospital in Tochigi Prefecture, Japan between 2009 and 2011

Characteristics of patients with bee sting, centipede bite, or viper bite treated at Ashikaga Red Cross Hospital in Tochigi Prefecture, Japan between 2009 and 2011

Acute ST-segment elevation myocardial infarction from a centipede bite

Acute myocardial infarction (AMI) following a centipede bite has been very rarely reported. Here, we describe a 22 year-old man who had ST-segment elevation AMI after a centipede bite. He presented with typical chest pain, electro and echocardiographic abnormalities, and elevated cardiac enzymes with normal coronary angiography. The probable mechanisms were described. Practitioners treating centipede bites shall not consider it lightly, as centipede envenomation may produce a variety of systemic and local manifestations in susceptible individuals.

Comparisons of ice packs, hot water immersion, and analgesia injection for the treatment of centipede envenomations in Taiwan

Objective. To compare the effectiveness of ice packs and hot water immersion for the treatment of centipede envenomations. Methods. Sixty patients envenomated by centipedes were randomized into three groups and were treated with ice packs, hot water immersion, or analgesia injection. The visual analog score (VAS) for pain was measured before the treatment and 15 min afterward. Demographic data and data on local and systemic effects after centipede bites were collected. The VAS scores and the pain decrease (ΔVAS) were compared between the three groups. Results. All patients suffered from pain at the affected sites; other local effects included redness (n = 49, 81.7%), swelling (n = 32, 53.3%), heat (n = 14, 23.3%), itchiness (n = 5, 8.3), and bullae formation (n = 3, 5.0%). Rare systemic effects were reported. All three groups had similar VAS scores before and after treatment. They also had similar effectiveness in reducing pain caused by centipedes bites (ΔVAS = 2.55 ± 1.88, 2.33 ± 1.78, and 1.55 ± 1.68, with ice packs, analgesia, and hot water immersion, respectively, p = 0.165). Conclusion. Ice packs, hot water immersion, and analgesics all improved the pain from centipede envenomation. Ice pack treatment is a safe, inexpensive, and non-invasive method for pre-hospital management in patients with centipede envenomation.

Dermohypodermite bactérienne et phlegmon du membre supérieur par morsure de scolopendre : à propos de deux cas

Centipede bites occurring in tropical countries are rare, however vigilance must be exercised during activities in the open air and dwellings should be checked in the event of rain. The bite is very painful and can be accompanied by generalised signs. An initial wound disinfection and a check of antitetanus vaccination status is all that is usually needed to ensure an uneventful outcome. There are however, rare cases where local toxicity and a bacterial super-infection, often with Gram+ cocci, can lead to a cellulitis or even necrotizing fasciitis of the hand. The diagnosis of a centipede bite can be made by the double marks made by the fangs. Wound debridement and antibiotics led to a good outcome in both our cases.

Epidemiology of centipede exposures reported to Texas poison control centers, 1998–2004

Centipedes are found globally, including the southern United States. Although centipede bites may cause pain, the bite is generally not considered life threatening. The present retrospective investigation studied the epidemiology of centipede exposures reported to Texas poison control centers. Cases were all human exposures reported during 1998–2004 that involved centipedes. There were totally 851 cases. Among the cases with a known patient age, 16% were less than 6 years of age, 19% were 6–19, and 65% were greater than 19 years. Females accounted for 55% of the patients with known gender. The reported centipede exposures were managed on site (outside of a health care facility) in 93% of the cases. Of the 305 cases with a known clinical outcome, 82% had minor effects. Cases exhibited a seasonal trend, with most of the reports occurring during July–September. There was no clear geographic pattern to the reported centipede exposures, although the highest rate occurred in West Texas. Dermal irritation or pain was reported in 73% of cases and the treatment by decontamination via irrigation was reported for 76% of the cases during 2000–2004.