Envenomation by Caterpillars

Abstract

In recent years, injuries resulting from human contact with Lepidoptera species have become an increasing health problem in different regions around the world, occasionally with epidemic features. The majority of medically significant contacts with Lepidoptera occur with exposure to the larva form. Adverse effects are often treated with antipruritic and oral antihistamines. In the case of South American Lonomia obliqua caterpillar, however, it was necessary to develop a specific antivenom to neutralize the severe coagulation disorders in patients. Toxic principles related to the envenoming are found in setae secretion and hemolymph in larvae (erucism) and, in a few cases, in urticant hairs in adult moths (lepidopterism). These compounds are responsible for many toxic or allergic reactions in different organisms, such as local pain, inflammation, itching, irritation, and, in more severe cases, deforming arthritis, consumption coagulopathy, and hemorrhage. Despite clear documentation of adverse reaction in humans due to some species of Lepidoptera, very few studies were carried out as an attempt to understand the pathophysiological mechanism of the envenoming and toxins involved. This chapter reviews currently available information about Lepidoptera's toxic species and relates, when possible, its properties with clinical data that have been described so far.