Centipede Envenomation Workup

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

Laboratory Studies

The following laboratory studies may be appropriate for centipede envenomation:

  • A bedside urine test for proteinuria is reasonable. [11] The same test can detect myoglobinuria secondary to rhabdomyolysis in patients with significant swelling and pain of the affected extremity.
  • If evidence of rhabdomyolysis is present, serum electrolytes, CPK, and renal function studies should be obtained.

A complete blood cell count, if done, may reveal a neutrophilic leukocytosis.

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Other Tests

An ECG should be obtained if the patient has a history of cardiac disease, chest pain, palpitations, or if there is any evidence of hemodynamic instability following centipede sting.

If the ECG is abnormal in the setting of chest pain following centipede sting, serum cardiac biomarkers (eg, troponins) should be checked.

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Procedures

If swelling of the affected extremity is severe and a compartment syndrome is suspected, intracompartmental pressures should be objectively assessed.

If a compartment syndrome is diagnosed, the limb should be elevated and plans should be made for fasciotomy. A brief trial of intravenous mannitol can be instituted in an effort to reduce pressures before surgery.

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