Approach Considerations

Any millepede secretions on the patient's skin should be washed away with soap and water.

Eye exposure should be treated similarly to corneal burns, with prompt immediate instillation of local anesthetic drops, followed by copious irrigation with saline solution or water.^{[13, 21]} In consultation with ophthalmology, topical antimicrobials and topical steroids can be considered.^[13]

Adequate tetanus immunization status should be ensured.

Topical steroid creams may be beneficial for local skin irritation.

Prevention

Beyond avoidance of handling millipedes, little deterrence is required.

Long-Term Monitoring

Follow-up care is generally unnecessary for millipede envenomation unless local complications ensue or the eyes are involved.

In ocular cases, the patient should be examined daily until the eye is healed.

Medication

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Media Gallery

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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Author

Steven A Lorber, MD, FAAEM, FACEP Assistant Professor, Interim Chief, Division of Emergency Medicine, St Louis University Hospital

Steven A Lorber, MD, FAAEM, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Preeti Dalawari, MD, MSPH, FAAEM, FACEP Associate Professor, Director of Research, Department of Surgery, Division of Emergency Medicine, St Louis University School of Medicine; Attending Physician in Emergency Medicine, St Louis University Hospital

Preeti Dalawari, MD, MSPH, FAAEM, FACEP is a member of the following medical societies: Academy for Women in Academic Emergency Medicine, American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

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, Vice-Chair in Charge of Research, Department of Emergency Medicine, Kings County Hospital Center

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

Disclosure: Nothing to disclose.

Chief Editor

Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center

Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Robert L Norris, MD Professor Emeritus, Department of Emergency Medicine, Stanford University Medical Center

Robert L Norris, MD is a member of the following medical societies: American College of Emergency Physicians, Wilderness Medical Society

Disclosure: Nothing to disclose.

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

Disclosure: Nothing to disclose.

Millipede Envenomation Treatment & Management

Approach Considerations

Prevention

Long-Term Monitoring

References

Tables

Contributor Information and Disclosures

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