Hemorrhagic syndrome associated with contact with Lonomia sp (Lepidoptera, Saturniidae) in Venezuela

Abstract

Introduction: Among the Lepidoptera, belonging to the class Insecta, only the larval forms of the genus Lonomia can cause systemic reactions in humans. So far, only two species have been formally linked to poisoning accidents: Lonomia achelous and Lonomia obliqua. Its venom is composed of proteins, serine proteases, and other components with inflammatory, procoagulant, and hemolytic activity.

Objective: Describe a case of hemorrhagic syndrome associated with contact with Lonomia achelous. Thus, trying to provide information on a condition of great clinical and health relevance for the Latin American region.

Clinical case: A 12-year-old patient, from a rural area, with no relevant family or personal history, who after contact with a caterpillar on the left forearm, presented local pain, fever, bruising in the submental region, right upper extremity and both lower extremities. In blood analysis, prolonged coagulation times were evidenced. Therefore, the diagnosis was considered lonomic accident. Two units of fresh frozen plasma and ε-aminocaproic acid were administered, presenting progressive clinical and analytical improvement, with normalization of coagulation parameters on the fifth day after admission.

Conclusions: For its diagnosis, the clinical manifestations presented by the patient with the observation of the caterpillar was important. The administration of antilonomic serum is the recommended treatment in Brazil, however, in this case good results were obtained with the administration of ε-aminocaproic acid. Due to his presentation in different Latin American countries, it is important to provide health professionals with knowledge about its diagnosis and therapeutic management.