Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Dusit, Bangkok, Thailand.
Department of Emergency Medicine, Phrae Hospital, Amphur Muang, Phrae, Thailand.
Clin Toxicol (Phila). 2021 Aug;59(8):721-726. doi: 10.1080/15563650.2020.1865543. Epub 2021 Jan 21.
Centipede envenomation occurs commonly in tropical and subtropical countries. In most cases, centipede envenomation causes benign clinical manifestations. Serious complications are reported occasionally. Clinical studies regarding centipede envenomation are limited to case reports and case series. This study aimed to determine the prevalence and clinical characteristics of centipede bites in Bangkok, Thailand.
This was a retrospective medical record review study. We included patients who were clearly envenomated by a centipede presenting to the emergency department of a tertiary university hospital in Bangkok from January 1, 2006, to December 31, 2015. Data were collected on demographics, details of the exposure, signs, symptoms, treatment, and complications of envenomation.
A total of 245 cases were included. The prevalence of centipede bite was 0.0367%. The majority were female (56.7%). The median age was 34.6 years (range: 1 month to 90 years). The number of envenomations was highest from October through December. Feet (38.3%) and hands (19.1%) were the parts of the body most often envenomated. Local effects were common with 99.5% of patients having localized pain and 87% having local swelling at the bite site. In terms of systemic effects, urticarial rash (5.7%) and fever (4.1%) were most frequently observed. Twelve cases (5%) had clinical pictures compatible with anaphylaxis. For pain management, all patients who had pain received analgesic drugs, while 29.7% were injected with local anesthesia. Antibiotics, antihistamines, and steroids were prescribed in 53.9%, 20.4%, and 10.2% of cases, respectively. No deaths occurred in this study.
Even though the location of our hospital is in a metropolitan city in Thailand, there were centipede bites every month, especially during the last three months of each year. Nearly all patients had local effects. In contrast, serious complications such as anaphylaxis and systemic infection only occurred occasionally.
蜈蚣咬伤在热带和亚热带国家很常见。在大多数情况下，蜈蚣咬伤表现为良性临床症状。偶尔会报告严重的并发症。关于蜈蚣咬伤的临床研究仅限于病例报告和病例系列。本研究旨在确定泰国曼谷蜈蚣咬伤的流行率和临床特征。
这是一项回顾性病历回顾研究。我们纳入了 2006 年 1 月 1 日至 2015 年 12 月 31 日期间因被蜈蚣咬伤而到曼谷一所三级大学医院急诊科就诊的明确被蜈蚣咬伤的患者。收集了人口统计学、暴露细节、体征、症状、治疗和咬伤并发症的数据。
共纳入 245 例患者。蜈蚣咬伤的发生率为 0.0367%。大多数为女性（56.7%）。中位年龄为 34.6 岁（范围：1 个月至 90 岁）。咬伤的发生数量在 10 月至 12 月最高。脚（38.3%）和手（19.1%）是最常被咬伤的身体部位。局部效应很常见，99.5%的患者有局部疼痛，87%的患者咬伤部位有局部肿胀。就全身效应而言，观察到最常见的是荨麻疹皮疹（5.7%）和发热（4.1%）。12 例（5%）有符合过敏反应的临床图片。为了缓解疼痛，所有有疼痛的患者都接受了止痛药，而 29.7%的患者接受了局部麻醉。分别有 53.9%、20.4%和 10.2%的患者接受了抗生素、抗组胺药和类固醇治疗。本研究无死亡病例。
尽管我们医院位于泰国的一个大都市区，但每个月都有蜈蚣咬伤，尤其是每年的最后三个月。几乎所有患者都有局部效应。相比之下，过敏反应和全身感染等严重并发症只是偶尔发生。
