IntroductionThe increasing incidence of new diseases as well as changing features of known diseases has partly been attributed to the impact of environmental changes. As a result, there have been calls from health experts for proper surveillance and monitoring of these changes.This is a report of mopane worm allergy in a 36 year old female from the Tswana tribe in Botswana. Mopane worm, the caterpillar stage of Gonimbrasia belina moths, is a seasonal delicacy to people in many communities in southern Africa. As a result, by adulthood, many residents of these communities have had substantial exposure to the worm. Gonimbrasia belina moths belong to the Lepidoptera order of insects. Though some members of this order are known to induce contact allergy, there is no reported incidence of ingestion allergy from mopane worm. Therefore, it is important to track this case for its epidemiological significance and to alert both clinicians and the vulnerable public on the incidence of mopane worm allergy in this region.Case presentationThis is a case of a 36 year old woman from the Tswana ethnic group in Botswana, who was diagnosed with food allergy. She presented with itchy skin rash, facial swelling, and mild hypotension after eating mopane worm. She had no previous history of allergic reaction following contact or ingestion of mopane worm and had no atopic illness in the past. She was treated and her symptoms resolved after 4 days.ConclusionThe proper management of allergy involves patients' avoidance and clinicians' predictability. Though hypothetical, this report is expected to sensitize clinicians to anticipate and properly manage subsequent occurrence, as well as educate the public in these communities. In addition, tracking new disease patterns, with relationship to environmental changes, will compliment existing evidence in validating the importance of proper environmental surveillance and management.