Millipede Envenomation Treatment & Management

  • Author: Robert L Norris, MD; Chief Editor: Scott H Plantz, MD, FAAEM   more...
 
Updated: Mar 22, 2012
 

Prehospital Care

  • Any millepede secretions on the patient's skin should be washed away with soap and water.
  • If the eyes are involved, they should be copiously washed with water as soon as possible.
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Emergency Department Care

  • The exposed skin should be washed thoroughly with soap and water.
  • Eye exposure should prompt immediate instillation of local anesthetic drops, followed by copious irrigation with saline solution or water.[11]
  • Adequate tetanus immunization status should be ensured.
  • Topical steroid creams may be beneficial for local skin irritation.
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Contributor Information and Disclosures
Author

Robert L Norris, MD  Professor, Department of Surgery, Chief, Division of Emergency Medicine, Stanford University Medical Center

Robert L Norris, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, California Medical Association, International Society of Toxinology, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

James Li, MD  Former Assistant Professor, Division of Emergency Medicine, Harvard Medical School; Board of Directors, Remote Medicine

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Richard H Sinert, DO  Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Scott H Plantz, MD, FAAEM  Associate Clinical Professor of Emergency Medicine, Rosalind Franklin University of Medicine and Science, Chicago Medical School; Medical Director, WeCare Med, Inc

Scott H Plantz, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

References

  1. Hare T. Poisonous Dwellers of the Desert. Tucson, AZ: Southwest Parks and Monuments Association; 1995.

  2. Peters S. A Colour Atlas of Arthropods in Clinical Medicine. Barcelona, Spain: Wolfe Publishing Ltd; 1992.

  3. Williams LA, Singh PD, Caleb-Williams LS. Biology and biological action of the defensive secretion from a Jamaican millipede. Naturwissenschaften. 1997;84(4):143-4. [Medline].

  4. Shimizu N, Kuwahara Y, Yakumaru R, Tanabe T. n-Hexyl laurate and fourteen related fatty acid esters: new secretory compounds from the julid millipede, Anaulaciulus sp. J Chem Ecol. Jan 2012;38(1):23-8. [Medline].

  5. Hendrickson RG. Millipede exposure. Clin Toxicol (Phila). 2005;43(3):211-2. [Medline].

  6. Mason GH, Thomson HD, Fergin P, Anderson R. Spot diagnosis. The burning millipede. Med J Aust. Jun 6 1994;160(11):718, 726. [Medline].

  7. Radford AJ. Giant millipede burns in Papua New Guinea. P N G Med J. Sep 1976;18(3):138-41. [Medline].

  8. Radford AJ. Millipede burns in man. Trop Geogr Med. Sep 1975;27(3):279-87. [Medline].

  9. Dar NR, Raza N, Rehman SB. Millipede burn at an unusual site mimicking child abuse in an 8-year-old girl. Clin Pediatr (Phila). Jun 2008;47(5):490-2. [Medline].

  10. De Capitani EM, Vieira RJ, Bucaretchi F, Fernandes LC, Toledo AS, Camargo AC. Human accidents involving Rhinocricus spp., a common millipede genus observed in urban areas of Brazil. Clin Toxicol (Phila). Mar 2011;49(3):187-90. [Medline].

  11. Hudson BJ, Parsons GA. Giant millipede 'burns' and the eye. Trans R Soc Trop Med Hyg. Mar-Apr 1997;91(2):183-5. [Medline].

 
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The desert millipede, Orthoporus ornatus. Photo by Robert Norris, MD.
The desert millipede, Orthoporus ornatus. Photo by Robert Norris, MD.
Millipede contact injury on day 3 following exposure.
 
 
 
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