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Centipede envenomation
Other Resources UpToDate PubMed

Centipede envenomation

Contributors: Robert Norris MD, Joanne Feldman MD, MS
Other Resources UpToDate PubMed

Synopsis

Centipedes are elongated, multisegmented arthropods with 1 pair of legs per body segment. They are found worldwide in warm, temperate, and tropical regions, where they typically live underground. They are nocturnal hunters, preying mostly on invertebrates, and are fast moving.

Centipedes have between 15 and 100 body segments. The first segment bears claws with venom glands at their bases. The venom is primarily used to kill prey and contains a complex mixture of proteins, histamine, and serotonin that is not well studied.

Centipede stings typically cause severe, burning pain, local swelling, redness, pruritus, and lymphadenopathy. Systemic symptoms include nausea, vomiting, headache, palpitations, and anxiety. Hemorrhagic vesicles, ulceration, and local necrosis can occur at the sting site. Death is rare, with only 3 reported cases in the literature. Proteinuria, rhabdomyolysis, a case of myocardial ischemia, and another case of myocardial infarction have also been reported.

Codes

ICD10CM:
T63.411A – Toxic effect of venom of centipedes and venomous millipedes, accidental, initial encounter

SNOMEDCT:
217677005 – Poisoning due to centipede venom

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Last Updated:02/19/2018
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Patient Information for Centipede envenomation
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Contributors: Medical staff writer

Overview

Centipedes are multi-segmented, long, flattened arthropods (related to spiders and flies). They can have more than 100 body segments and move quickly when they come out from under rocks or above ground to hunt at night. They are found worldwide. They use their pincers to poison and grasp their prey.

When humans are stung by centipede pincers, the stings are usually mild and symptoms clear within hours.

Who’s At Risk

You are at risk if you are outdoors and exposed to centipedes. If you have an outdoor hobby or profession such as landscaping or gardening, your risk of getting stung by a centipede increases.

Signs & Symptoms

Common symptoms of centipede envenomation are:
  • Severe burning pain
  • Itching, swelling, and redness or bruising at the sting site
  • Headache
  • Chest pain
  • Palpitations and anxiety
  • Painful and swollen lymph nodes
  • Nausea and vomiting

Rarely, cardiovascular or other complications may occur that require emergency care.

Self-Care Guidelines

You may find relief by using one or more of these treatments:
  • Apply ice to the affected site for pain and swelling
  • Use an over-the-counter pain reliever, such as acetaminophen (Tylenol) for pain and swelling
  • Use an over-the counter antihistamine for itching

When to Seek Medical Care

If the affected area continues to get more painful or does not improve with time, seek medical attention.

Treatments

Your health care provider may call for:
  • A  local injectable anesthetic to reduce pain
  • A tetanus shot, if needed
  • Monitoring your condition for 4 hours to watch for toxic reactions
  • Oral and/or prescription antihistamines if over-the-counter antihistamines are insufficient to relieve itching
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Centipede envenomation
A medical illustration showing key findings of Centipede envenomation : Bite or trauma site, Edema, Painful skin lesions
Clinical image of Centipede envenomation - imageId=3590859. Click to open in gallery.  caption: 'Erythematous papules and thin plaques, some linear in configuration, on the flank.'
Erythematous papules and thin plaques, some linear in configuration, on the flank.
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