Life-threatening facial edema due to pine caterpillar mimicking an allergic event
| Autor: | Ayfer Inal, H. Korkmaz Güvenmez, D. Ufuk Altintas, S. Güneşer Kendirli, Mehmet Bertan Yilmaz |
|---|---|
| Přispěvatelé: | Çukurova Üniversitesi |
| Rok vydání: | 2006 |
| Předmět: |
Hypersensitivity
Immediate Male Pulmonary and Respiratory Medicine medicine.medical_specialty Urticaria Glossitis medicine.medical_treatment Immunology Moths Dexamethasone Diagnosis Differential Tongue Edema Intubation Intratracheal medicine Animals Humans Immunology and Allergy Intubation Angioedema Toxins Biological Respiratory distress Pheniramine business.industry Thaumetopoea pityocampa fungi Infant Insect Bites and Stings General Medicine Airway obstruction medicine.disease Dermatology Surgery Airway Obstruction Airway Pine processionary caterpillar Insect Proteins medicine.symptom business Anaphylaxis |
| Zdroj: | Allergologia et Immunopathologia. 34:171-173 |
| ISSN: | 0301-0546 |
| DOI: | 10.1157/13091043 |
| Popis: | PubMedID: 16854350 Background: Approximately 150 species of Lepidoptera have been described as causing damage to human skin. One of these species is the pine processionary caterpillar, which is responsible for dermatitis, contact urticaria, ocular lesions and rarely respiratory signs and anaphylactic reactions through IgE-mediated or non-IgE-mediated mechanisms. We report a pediatric case of severe orofacial edema mimicking an allergic reaction after ingestion of a pine processionary caterpillar; urgent airway intubation was required. Case report: A 15-month-old boy was sleeping under a pine tree when his mother noted a pine caterpillar on his tongue. Because of rapidly developing facial swelling and respiratory distress, the infant was first taken to a local hospital where he received intravenous dexamethasone and pheniramine hydrogen maleate. On arrival at our emergency department, diffuse swelling and edema involving the tongue, perioral, nasal and perimandibular regions, and neck was noted, requiring urgent orotracheal intubation. There were no findings of anaphylaxis. The results of skin prick tests and specific IgE to common aero- and food allergens were negative. A skin prick test with extract of pine caterpillar was also negative. Prednisolone and pheniramine hydrogen maleate were administered for 7 days. The child gradually improved and was successfully extubated 4 days later. Conclusion: Although oral contact with a pine processionary caterpillar in the form of ingestion is rare, it may cause significant local reaction and airway compromise mimicking an allergic event. In this situation, early intubation to maintain airway patency is a life-saving measure. |
| Databáze: | OpenAIRE |
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