Centipede Envenomation Clinical Presentation

Updated: May 04, 2017
  • Author: Robert L Norris, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Presentation

History

The history of a centipede sting is usually straightforward. The victim (frequently a gardener) typically sees the creature. Patients may note the following:

  • Severe pain (worse with larger specimens)

  • Local tissue swelling

  • Redness

  • Swollen, painful lymph nodes

  • Headache

  • Chest pain

  • Palpitations

  • Nausea and/or vomiting

  • Anxiety

  • Local pruritus

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Physical Examination

Physical findings due to centipede envenomation may include the following:

  • Local edema

  • Small puncture wounds (may be hard to see)

  • Erythema [10]

  • Ecchymosis

  • Lymphangitis and/or lymphadenopathy

  • Occasionally vesicles or blisters

  • Possibility of local necrosis

  • The patient may be noticeably uncomfortable or anxious

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Complications

Complications of centipede envenomation may include the following:

  • Secondary infection

  • Wound necrosis (uncommon)

  • Rare compartment syndrome, rhabdomyolysis, myoglobinuria, and acute renal failure

  • Possible coronary vasospasm and acute myocardial infarction
  • Anaphylaxis (Patients with a history of hymenoptera sensitivity may be at higher risk. [1] )

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