Laboratory Studies

Laboratory studies are generally not required for caterpillar stings unless evidence of coagulopathy is present, as in some New World caterpillars in the family Saturniidae (Lonomia species). Those that may be warranted include the following:

Hematology: CBC
Coagulation studies: Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen level, fibrin degradation products, D-dimer assay, urine bedside test for blood
Renal function studies: Creatinine, BUN

Imaging Studies

A chest radiograph is reasonable if the patient has significant respiratory symptoms.

Treatment & Management

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Media Gallery

Caterpillar envenomations. Puss caterpillar or asp. Photo courtesy of the Arizona Poison and Drug Information Center.
Distinguishing dangerous from harmless caterpillars can be difficult, and handling any caterpillar with bare skin should be avoided. These are harmless tomato hornworm caterpillars (larval form of the five-spotted hawk moth [Manduca quinquemaculata])

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Author

Andrew G Park, DO, MPH, FAWM Assistant Professor, Department of Emergency Medicine, Department of Preventative Medicine and Public Health, University of Kansas Medical Center

Andrew G Park, DO, MPH, FAWM is a member of the following medical societies: Wilderness Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Jonathan Bauman, MD Resident Physician, Department of Emergency Medicine, University of Kansas Medical Center

Jonathan Bauman, MD is a member of the following medical societies: American College of Emergency Physicians, Emergency Medicine Residents' Association, Wilderness Medical Society

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.

Gino A Farina, MD, FACEP, FAAEM Professor of Emergency Medicine, Hofstra North Shore-LIJ School of Medicine at Hofstra University; Program Director, Department of Emergency Medicine, Long Island Jewish Medical Center

Gino A Farina, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency 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.

Samuel M Keim, MD, MS Professor and Chair, Department of Emergency Medicine, University of Arizona College of Medicine

Samuel M Keim, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.