Page 109 - JSOM Winter 2021

for multiple days. Similar to bee venom, centipede venom has within living quarters should be removed carefully as they are
been implicated as a rare cause of widespread urticaria and aggressive and may strike at bare hands or feet. Proper wound
anaphylaxis, typically occurring within minutes to hours of care should be emphasized and adequate analgesia provided in
the sting. order to minimize the risk of complications and lost duty days.

The most commonly reported complications occurring within Disclaimer
days to weeks of centipede envenomation include localized The opinions and assertions expressed herein are those of the
tissue necrosis and cellulitis. These complications are still authors and do not reflect the official policy or position of
thought to be relatively uncommon. There are isolated case the Uniformed Services University of the Health Sciences, the
reports of more severe reactions, in which centipede venom Department of the Army, the Department of Defense, or the
was the suspected trigger for rhabdomyolysis and acute kidney US Government.
injury, acute myocardial infarction, and eosinophilic cellulitis
(Well syndrome). There are few well-authenticated reports of Disclosure
death from centipede envenomation, typically in pediatric pa- The authors have nothing to disclose.
tients such as a 7-year-old girl who died in the Philippines after
being bit in the scalp. Bibliography
Aziz H, Rhee P, Pandit V, et al. The current concepts in management
of animal (dog, cat, snake, scorpion) and human bite wounds.
Management J Trauma Acute Care Surg. 2015;78(3):641-648. doi:10.1097/TA.
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While there is a paucity of published data on centipede bites Bush SP, King BO, Norris RL, Stockwell SA. Centipede envenom-
to guide evidence-based management, there appears to be a ation. Wilderness Environ Med. 2001;12(2):93–99. doi: 10.1580/
general consensus among providers in some Scolopendra- 1080-6032(2001)012[0093:ce]2.0.co;2. PMID: 11434497.
endemic areas, such as Hawaii, on how best to address centi- Changratanakorn C, Fasawang N, Chenthanakit B, et al. Effective-
pede bites. Irrigation and washing with soap and water may ness of antibiotic prophylaxis in patients with centipede stings:
help reduce the risk of secondary infection. It is also com- a randomized controlled trial. Clin Exp Emerg Med. 2021;8
monly believed that warm water may help neutralize toxins (1):43–47. doi:10.15441/ceem.20.110. PMID: 33845522; PMCID:
PMC8041584.
found in centipede venom. Oral or topical analgesics as well as Chu Y, Qiu P, Yu R. Centipede venom peptides acting on ion channels.
antihistamines seem to be an effective measure to help mitigate Toxins (Basel). 2020;12(4):230. doi:10.3390/toxins12040230.
the intense pain associated with centipede stings. In addition PMID: 32260499. PMCID: PMC7232367.
to providing analgesia and ensuring proper wound care, it is Fenderson JL. Centipede envenomation: bringing the pain to Hawai’i
recommended that providers assess patients for tetanus immu- and Pacific Islands. Hawaii J Med Public Health. 2014;73(11
nization status following centipede stings. Suppl 2):41–43. PMID: 25478303; PMCID: PMC4244901.
Friedman IS, Phelps RG, Baral J, Sapadin AN. Wells’ syndrome trig-
gered by centipede bite. Int J Derm. 1998;37(8):602–605. doi:
Although the incidence of secondary infection in centipede 10.1046/j.1365–4362.1998.00570.x
bites is believed to be low, case reports of severe infections Goddard J. Physician’s guide to arthropods of medical importance,
requiring intensive antibiotic therapy and even surgical de- fifth edition. ProQuest Ebook Central; 2007. https://ebookcentral
bridement have led to some providers to consider prophylactic -proquest-com.usu01.idm.oclc.org
antibiotic therapy. Guerrero AP. Centipede bites in Hawai’i: a brief case report and re-
view of the literature. Hawaii Med J. 2007;66(5):125–127. PMID:
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A recent randomized controlled trial from two emergency de- Harada S, Yoshizaki Y, Natsuaki M, et al. Three cases of centipede
partments in Thailand suggested that antibiotic prophylaxis allergy: analysis of cross reactivity with bee allergy. Arerugi. 2005;
was not an effective means of preventing secondary infection 54(11):1279-1284. doi:10.15036/arerugi.54.1279
from centipede bites. Nonetheless, patients should be in- Kang S, Liu Y, Zeng X, et al. Taxonomy and identification of the
structed in proper wound care and given return precautions genus Scolopendra in China using integrated methods of external
for signs of new infection in the days to weeks following the morphology and molecular phylogenetics. Sci Rep. 2017;7:16032.
https://doi.org/10.1038/s41598-017-15242-7
bite, such as increased redness, swelling, pain and lymphangi- Logan JL, Ogden DA. Rhabdomyolysis and acute renal failure fol-
tis. For patients diagnosed with secondary cellulitis, empiric lowing the bite of the giant desert centipede Scolopendra heros.
antibiotic therapy should cover skin flora as well as some West J Med. 1985;142(4):549–550. PMID: 4013269; PMCID:
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lin-clavulanate or a first-generation cephalosporin. Mundel P. (1990) Soil Biology Guide. D.L. Dindal, ed. Wiley Inter-
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Scolopendra centipedes are endemic to many areas in which Yildiz A, Biçeroglu S, Yakut N, et al. Acute myocardial infarction in
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