Shen Yi-Syun, Hu Chao-Chien
Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
Taiwan J Ophthalmol. 2017 Oct-Dec;7(4):221-223. doi: 10.4103/tjo.tjo_32_17.
The brown marmorated stink bug is native to Asia (China, Taiwan, Japan, and the Korean peninsula). Its bodily fluids are toxic and irritating to the human skin and eyes. Human case reports are rare. Only one report of irritant contact dermatitis has been published. We report a case of irritant contact keratitis resulting from the chemical components of the bodily fluids of the bug.
A case report.
A 74-year-old male presented to our emergency department with pain and redness in his right eye, which had been exposed to the bodily fluids of a brown marmorated stink bug. A patch of central corneal epithelial defect with conjunctival congestion and chemosis was found in his right eye. His best-corrected visual acuity (BCVA) (OD) was 6/20. We prescribed topical antibiotic and lubricant medications. The corneal epithelial defect recovered gradually over the course of several days. BCVA worsened to 2/60 but recovered gradually to 6/8.6 after the epithelial defect healed and after use of topical steroid for suppression of the local inflammation.
The adult brown marmorated stink bug is characterized by its shield shape and its dark, mottled, brown color. The stink bug ranges in length from 14 to 17 mm. A startled stink bug will react by biting or spraying a foul-smelling liquid from its thorax. When disturbed or crushed, the stink bug excretes a highly potent, odorous smell. The major component of the bodily fluids is trans-2-decenal and trans-2-octenal, chemicals that belong to the aldehyde group. Hydrogen ions (H) produced by reduction and oxidation of aldehyde can induce chemical burn injuries to the ocular surface. Irritant contact keratitis may occur through this mechanism.
Stink bugs excrete odorous bodily fluids as a defensive mechanism when threatened. If the toxic fluid gets into the human eye, it can cause unexpected chemical burns or injury. Patients whose eyes come into contact with these bodily fluids should rinse their eyes thoroughly and immediately seek medical attention.
褐纹蝽原产于亚洲（中国、台湾、日本和朝鲜半岛）。其体液对人体皮肤和眼睛有毒且具有刺激性。人类病例报告较为罕见。仅发表过一例刺激性接触性皮炎的报告。我们报告一例由该蝽体液化学成分导致的刺激性接触性角膜炎病例。
病例报告。
一名74岁男性因右眼接触褐纹蝽体液后出现疼痛和眼红而就诊于我院急诊科。右眼发现一片中央角膜上皮缺损，伴有结膜充血和水肿。其右眼最佳矫正视力（BCVA）（OD）为6/20。我们开具了局部抗生素和润滑剂药物。角膜上皮缺损在数天内逐渐恢复。BCVA恶化至2/60，但在角膜上皮缺损愈合且使用局部类固醇药物抑制局部炎症后逐渐恢复至6/8.6。
成年褐纹蝽的特征是其盾形以及深色、斑驳的褐色。蝽的体长在14至17毫米之间。受到惊吓的蝽会通过叮咬或从胸部喷出恶臭液体来做出反应。当受到干扰或挤压时，蝽会排出一种气味浓烈的恶臭。体液的主要成分是反-2-癸烯醛和反-2-辛烯醛，这些化学物质属于醛类。醛的氧化还原产生的氢离子（H）可导致眼表化学烧伤。刺激性接触性角膜炎可能通过这种机制发生。
蝽在受到威胁时会排出有气味的体液作为防御机制。如果有毒液体进入人眼，可能会导致意想不到的化学烧伤或损伤。眼睛接触到这些体液的患者应彻底冲洗眼睛并立即就医。
