澳大利亚蜈蚣咬伤的前瞻性研究。

Corrine R Balit, Mark S Harvey, Julianne M Waldock, Geoffrey K Isbister
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引用次数: 39

摘要

背景:有有限的报告,明确的咬人由蜈蚣专家鉴定,这是需要归因特定的临床效应不同的物种。目的:描述澳大利亚蜈蚣咬伤的临床效果。方法:对2000年12月至2002年3月间蜈蚣中毒报警电话进行前瞻性研究。收集的信息包括人口统计、暴露细节、局部影响、全身影响和治疗。收集到的蜈蚣经专家鉴定。所有受试者都被跟踪,直到临床效果消失。结果:48例蜈蚣暴露中,3例为蜈蚣摄入,无不良反应,1例为蜈蚣接触反应,导致红斑和迟发性瘙痒。在确定的44例蜈蚣咬伤中,获得并鉴定的14例蜈蚣属(5例)、Cormocephalus属(6例)和Ethmostigmus属(3例)。其中13例发生在远端(手或脚)。14例患者均出现疼痛,其中7例疼痛严重。发红/红痕53%,肿胀/凸起部位43%,瘙痒14%。没有系统性影响的报道。黄尾蛾和蜈蚣的影响更为严重。57%发生在室内,50%发生在夜间。治疗包括冰袋和单纯镇痛等支持措施,4例患者报告将咬伤区域浸入热水后疼痛缓解。在其他30例明确的蜈蚣咬伤中报告了类似的临床效果。结论:澳大利亚蜈蚣叮咬引起轻微影响,伴有中度至重度疼痛,并伴有局部肿胀和红斑。热水浸泡可能对蜈蚣咬伤有益。蜈蚣属分布在世界各地,研究结果可能具有国际适用性。
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Prospective study of centipede bites in Australia.

Background: There are limited reports of definite bites by centipedes with expert identification, which are required for attribution of particular clinical effects to different species.

Objective: To describe the clinical effects of centipede bites in Australia.

Methods: Prospective study of calls regarding centipede exposures to a state poison information center, from December 2000 to March 2002. Information collected included demographics, details of the exposure, local effects, systemic effects, and treatment. Collected centipedes were identified by an expert. All subjects were followed until clinical effects had resolved.

Results: Of 48 centipede exposures, 3 were centipede ingestions with no adverse effects and one was a contact reaction to the centipede that resulted in erythema and delayed itchiness. Of 44 definite centipede bites, the centipedes obtained and formally identified in 14 cases were from the genera Scolopendra (5), Cormocephalus (6), and Ethmostigmus (3). Of these 14 bites, 13 occurred distally (hands or feet). Pain occurred in all 14 cases and was severe in 7 patients. Redness/red mark occurred in 53%, swelling/raised area in 43%, and itchiness in 14%. No systemic effects were reported. Ethmostigmus spp. and Scolopendra spp. caused more severe effects. Of the bites, 57% occurred indoors and 50% at night. Treatment consisted of supportive measures including ice packs and simple analgesia, and 4 patients reported pain relief after immersing the bite area in hot water. Similar clinical effects were reported in the other 30 definite centipede bites.

Conclusions: Australian centipede bites cause minor effects with moderate to severe pain, associated with localized swelling and erythema in bites by the genera Ethmostigmus and Scolopendra. Hot water immersion may potentially be beneficial for centipede bites. The genus Scolopendra occurs worldwide and the results may have international applicability.

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