An Uncommon Bug Bite

​BY RYAN LYNCH, MD, & MARK SUPINO, MDA 2-year-old girl was playing outside when she spotted a furry caterpillar. Like her stuffed animals, it was fluffy and had long hair. She let the insect crawl on her legs, but then suddenly screamed in pain. Her parents brought her to the ED, though she was no longer in distress by the time she arrived.The patient had a large urticarial lesion on her inner right thigh and a smaller one on her left thigh. (Photo.) There were no puncture wounds, bite marks, or barbs visible or palpable. Her vital signs and physical exam were within normal limits. The patient's father had captured the culprit in an empty pill bottle and brought it to the ED for identification. (Photo.)Urticarial lesions prompting ED presentation.Megalopyge opercularis, known as the puss caterpillar, woolly slug, possum bug, or perrito (Spanish for little dog), is a moth found all over the United States. (United States Department of Agriculture. Department Circular 288. 1923; http://bit.ly/2Bdx6WG.) The larval caterpillar form has venomous long hair-like setae protruding from its body. (van Nieukerken EJ, et al. Order Lepidoptera Linnaeus, 1758. In: Animal Biodiversity: An Outline of Higher-Level Classification and Survey of Taxonomic Richness, Zhang ZQ (Ed), Magnolia Press: Auckland 2011. Vol 3148, p. 212.) Its fluffy, stuffed animal-like appearance is often confused, especially by children, for an innocuous caterpillar.Adverse reactions after...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research