Beware of the Caterpillar: Anaphylaxis to the Spotted Tussock Moth Caterpillar, <i>Lophocampa Maculata</i>

DuGar, Brandon; Sterbank, Julie; Tcheurekdjian, Haig; Hostoffer, Robert

doi:10.2500/ar.2014.5.0086

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…Another case report describes an anaphylactic reaction to the Lophocampa maculata species with cutaneous manifestations [7]. The patient's anaphylactic reaction manifested with an acute development of diffuse urticaria along with progressive dyspnea [7]. To our knowledge, this is the first reported case of oral cavity exposure to the Lophocampa maculata species, and we have reported on a method to remove the setae atraumatically in this location.…”

Section: Discussionmentioning

confidence: 95%

“…Balit et al have described in a report pertaining to the cutaneous manifestations of the white-stemmed gum moth that attempted removal of all setae is near impossible, non-essential and time consuming [6]. Another case report describes an anaphylactic reaction to the Lophocampa maculata species with cutaneous manifestations [7]. The patient's anaphylactic reaction manifested with an acute development of diffuse urticaria along with progressive dyspnea [7].…”

Section: Discussionmentioning

confidence: 99%

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A prickly situation: An attempted Caterpillar ingestion - case report

Bhardwaj

Fnais

Chin

2020

Journal of Otolaryngology - Head & Neck Surgery

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Background Foreign body ingestion is a common problem in pediatrics. Each foreign body can present its’ own unique challenges during removal, and we present the management of an ingested Spotted Tussock Moth (Lophocampa maculata), more commonly known as a caterpillar. Case presentation An 18-month-old boy presented to the emergency department with difficulty handling secretions and odynophagia. It was reported he had placed a caterpillar in his mouth and then spat it out. On examination, hundreds of miniscule filaments (setae) were seen embedded in his lips and tongue. Our service was consulted out of concern for airway involvement. The patient was taken to the operating room where a direct laryngoscopy under general anesthesia with spontaneous ventilation was performed to confirm the setae were confined to the anterior tongue and lips. Once we were satisfied the airway was stable, the airway was secured, and we then began to remove the setae. The initial method used was to use Adson-Brown forceps to remove the setae, however this proved difficult and time-consuming given the volume of setae and how thin the setae were. Ultimately, a more effective technique was developed: a 4 × 4 AMD-RITMES® gauze was applied to the mucosa in order to dry up any secretions and then a piece of pink, waterproof BSN medical® tape was applied to the mucosa. After 3 s of contact it was removed. This technique was then repeated and was used to remove the vast majority of the setae. Conclusion To our knowledge, we have described the first technique to remove the caterpillar setae from the oral cavity mucosa in a fast, safe and efficient manner.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

A prickly situation: An attempted Caterpillar ingestion - case report

Bhardwaj

Fnais

Chin

2020

Journal of Otolaryngology - Head & Neck Surgery

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“…7 Systemic Lepidopterism and anaphylaxis are less common than the localized dermatitis seen in this case, but it is pertinent to monitor for symptoms after an encounter and seek medical care immediately if symptoms arise. 2,8…”

Section: Discussionmentioning

confidence: 99%

The Sting of a White Flannel Moth Caterpillar (Norape ovina)

Michienzi

Holstege

Cole

et al. 2022

Wilderness & Environmental Medicine

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The purpose of this report is to describe a case of urticarial dermatitis, or erucism, caused by the white flannel moth caterpillar (Norape ovina) in central Virginia. Many caterpillars are known to cause erucism, with the puss caterpillar (Megalopyge opercularis) being the most reported culprit in the United States. White flannel moth caterpillars are expected to cause erucism as they belong to the same family as the puss caterpillar (Megalopygidae) and have similar venom-containing hairs, but no reports of the reaction or clinical course have been documented in the medical literature. A subject was stung by a white flannel moth caterpillar after it fell on his neck while clearing brush with a machete. The subject experienced immediate pain and developed a raised, erythematous rash where the caterpillar had fallen. The rash, referred to as erucism, was painful for 1 d and improved slowly over the course of 2 wk, but a small area of discoloration remained 2.5 mo after contact. Symptoms were managed by the subject at home and no medications were administered. The white flannel moth caterpillar inflicts erucism similar to that caused by the more commonly mentioned puss caterpillar. If only local symptoms are sustained from contact with a white flannel moth caterpillar, it can be safely and effectively managed with overthe-counter medications similar to the management for erucism induced by other caterpillar species. Irrigation and removal of urticating hairs with adhesive tape may help reduce the pain and is recommended, though not performed in this case.

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“…8 In contrast, in two studies in adults with a mean (standard deviation) age of 51 ± 16.9 years 9 and 44.3 years (interquartile range, 32–58 years), 10 respectively, food triggers were as common as drug triggers, followed by venom triggers, 9,10 honey ingestion, 11 and the spotted tussock moth caterpillar, Lophocampa maculate. 12 Idiopathic anaphylaxis is also reported. 13 In children, the most common trigger is food, with up to 90% of anaphylaxis due to food, followed by insect venom, and idiopathic anaphylaxis.…”

Section: Triggersmentioning

confidence: 98%