Clinical studies, case reports and reviews

Lonomia obliqua
Brazil (Rio Grande do Sul)
Duarte et al. 1993: 33 cases of contact with L. obliqua. Identification criteria not specified, 11 cases 0–12 years old, 15 cases 13–50 years, 7 cases >50 years.

Kowacs et al 2006: 1 case. Identification: morphological.

Megalopyge opercularis
USA
McGovern et al. 1961: 2,130 patients.
Pinson and Morgan 1991: 1 case. Identification: morphological.

Signs & symptoms

Autopharmacological effects

Megalopyge opercularis

Shock-like symptoms that occur within 2 h (autopharmacological reaction?) (104/2130) (McGovern et al. 1961).

Pulmonary symptoms caused by inhaled hairs (differential diagnosis allergic reaction – toxic).

Local effects

Lonomia obliqua

Local pain 33/33 (Duarte et al. 1993).

Megalopyge opercularis

Local pain, urticarial skin lesions with pruritus and a local haemorrhagic lesion (Pinson and Morgan 1991).

Strong local pain (2093/2130), local swelling (1964/2130), regional lymphadenopathy within 1 h (679/2130) (McGovern et al. 1961).

Haemostatic effects

Lonomia obliqua

Generalised ecchymosis 30/33, mucous membrane bleeding 22/33, haematuria 15/33, cerebral haemorrhage 4/33, pulmonary haemorrhage 1/33 (Duarte et al. 1993).

Multiple intracerebral haemorrhages (CCT) (Kowacs et al 2006).

Renal effects

Lonomia obliqua
Acute renal failure 6/33 (however, this was probably secondary in the context of disseminated intravascular coagulation) (Duarte et al. 1993).

Other signs & symptoms

Megalopyge opercularis

Headache that commences within minutes and can persist for up to 24 h (626/2130); cerebral seizures (5/2130) (McGovern et al. 1961).

Case fatality rate

Megalopyge opercularis

0/2130 (McGovern et al. 1961).

Lonomia obliqua
4/33. Cause of death: cerebral and pulmonary haemorrhage, acute renal failure (Duarte et al. 1993).

1/1. Cause of death: cerebral haemorrhage (Kowacs et al 2006).

Laboratory and physical investigations

Type of haemostatic defect
Lonomia obliqua
Fibrinogenolysis, pro-coagulative enzymes (Arocha-Pinango et al. 1988).

PT and PTT ↑, fibrinogen and platelets ↓ (first reading 5th day (day of admission) after contact, max 7th day after contact (time of death)) (Kowacs et al 2006).

First aid

Toxic hemolymph and caterpillar hairs  that have not yet penetrated the skin should immediately be removed: (1) soap-and-water washing, (2) no-touch drying of the sting site with a hair dryer (not a towel), stripping of the site with adhesive tape, rapidy trying fingernail polish, rubber cement or commercial facial peel solutions. These should then be allowed to dry under a hair dryer, and then peeled off the sting site. Removal of rings etc since the affected extremites may grossly swell. Ice packs to ease pain (McGovern et al. 1961, Diaz 2005).

Treatment

Symptomatic, including treatment of allergic complications (McGovern et al. 1961, Diaz 2005).