| Table 4-20 Select Arthropods and Other Creatures (Figures 4.41A–F, 4.42C, D and 4.43C, E) |
| |
Common Name |
|
Scientific Name and
Virulence Factor |
|
Clinical Presentation |
|
Treatment |
| |
Scorpion |
|
Centruroides spp.
Virulence: two poison glands
empty into stingers |
|
Pain and paresthesias, variable
swelling at site of sting, ± neurologic
or cardiop1ulmonary
complications |
|
Remove stinger, local
wound care, ice,
antihistamines |
| |
Myiasis |
|
Dermatobia hominis (botfly
larva) |
|
Larva penetrates into skin causing
pyogenic furuncle or “furuncular
myiasis” |
|
Extract maggot manually or
occlude with petrolatum |
| |
Centipedes
(Class: Chilopoda) |
|
Scolopendra spp.
Scutigera spp.
Virulence: nocturnal carnivores;
inject neurotoxic venom
through ducts in jaws |
|
Two hemorrhagic puncture wounds
at site of bite (form chevron shape),
± pain, edema, erythema, profuse
bleeding, and associated paresthesias |
|
Symptomatic treatment and
systemic antihistamine |
| |
Millipedes
(Class: Diplopoda) |
|
Virulence: harmless vegetarians
(do not bite) may emit
toxic substance |
|
Contact dermatitis to noxious
chemical with associated burning,
blistering, and/or pigmentation,
± severe inflammation of eyes
(if toxin squirted) |
|
Symptomatic treatment with
copious lavage to affected
site |
| |
Snake bites |
|
Crotalidae family: rattlesnake,
copperhead, and cottonmouth
moccasin
Elapidae family: coral snake
Virulence: venom (mainly
hydrolases) |
|
Rapid onset pain and swelling
(within hour of envenomation),
hemorrhage, and necrosis common
with paired bite marks |
|
Antivenom therapy, tetanus
prophylaxis, antibiotic if
needed |
| |
Bees, wasps,
hornets |
|
Virulence: phospholipase
(honey bee venom) |
|
Range from mild pain with local
edema to exaggerated reactions,
± generalized urticaria, angioedema,
respiratory distress, shock |
|
Remove stinger, ice,
symptomatic care |
| |
Fire ants |
|
Solenopsis spp.
Virulence: hemolytic factor, solenopsins (piperidine
alkaloids from venom of red
fire ant) |
|
Sterile pustule with erythematous
hemorrhagic halo, large urticarial
lesions, systemic neurologic
symptoms (if multiple bites),
± anaphylaxis, shock, and death |
|
Symptomatic care |
| |
Bed bugs |
|
Cimex lectularius (Small, reddish-brown with
oval-shape and banded
appearance) |
|
Pruritic macules and papules
typically involving exposed skin,
often grouped in three (“breakfast,
lunch, dinner”); peak occurrence
before sunrise |
|
Symptomatic care for skin
lesions; eliminate
infestation |
| |
Blister beetle |
|
Lytta vesicatoria
Virulence: cantharidin (blistering agent) |
|
Vesicles or bullae after contact with
skin |
|
Symptomatic care |
| |
Carpet beetle |
|
Anthrenus spp.
Attagenus spp.
(Shiny black and oval-shaped) |
|
May cause allergic papulovesicular
dermatitis on exposed areas (due to
adults or larvae) |
|
Symptomatic care |
| |
Sea urchin |
|
Virulence: fragile spines, break
easily into the skin |
|
Fragments of spines in skin, may
cause synovitis and arthritis if near
joints |
|
Remove spines |
| |
Sea bather’s
eruption |
|
Linuche unguicalata (thimble jellyfish larvae)
Edwardsiella lineate (sea anemone) |
|
Stinging larvae trapped beneath
swim-wear → pruritic papules under
covered areas (bathing suit
distribution) |
|
Symptomatic |
| |
Jellyfish stings |
|
Chironex fleckeri
(Pacific box jellyfish)
Physalia physalis
(Portuguese man of war)
Cyanea and Chrysaora
(sea nettles) |
|
Sting results in immediate pain,
delayed cutaneous reactions,
± shock |
|
|
| |
Tungiasis |
|
Tunga penetrans |
|
Flea burrows into upper dermis
(resembles abscess with black
center or punctum) and discharges
eggs from center |
|
|
| |
Caterpillars |
|
See Table 4-21
Urticating hairs (setae) |
|
Purely cutaneous reaction (erucisim)
or systemic symptoms without
cutaneous findings (lepidopterism) |
|
Removal of offending hairs
(duct tape stripping), topical
antipruritics |
| |
|
|
|
|
|
|
|
