Niña con erucismo hemorrágico por Lonomia spp. reporte de un caso

Abstract

RESUMENLos accidentes causados por las setas urticantes o venenosas de las orugas de lepidópteros, se conocen como erucismo. Estos accidentes se producen por el contacto accidental, especialmente por los niños, con las cerdas sobre el cuerpo del insecto, conectadas con glándulas venenosas. Los síntomas pueden ser locales o sistémicos, con presentaciones clínicas fatales. El accidente ocasionado por las orugas del género Lonomia spp. puede desencadenar síndromes hemorrágicos, constituyendo estos la forma más grave de erucismo. Se reporta el caso de una niña de 5 años, procedente del poblado de Villarondos, en la Amazonía del Perú, departamento de Huánuco, la cual incidentalmente se hinca con las cerdas de una oruga, cursando luego con anemia hemolítica, plaquetopenia y trastorno de la coagulación. El diagnóstico fue establecido por la anamnesis, cuadro clínico, exámenes de laboratorio y respuesta al suero antilonómico. Se discuten los aspectos clínicos, laboratoriales y terapéuticos de erucismo por Lonomia spp.Palabras clave: Erucismo, Lonomia spp, coagulación intravascular diseminada, trastorno de la coagulación (fuente: DeCS BIREME). HEMORRHAGIC ERUCISM DUE TO Lonomia spp. IN A GIRL:A CASE REPORT ABSTRACT Accidents caused by urticating or poisonous setae from lepidoptera caterpillars are known as erucism. These accidents are produced by accidental contact, especially in children, with bristles on the insect's body surface, connected to venom glands. Symptoms may be local or systemic, with deadly clinical presentations. The accident caused by Lonomia spp. caterpillars can trigger bleeding disorders, which is considered the most severe type of erucism. The case of a 5-year-old girl is reported. She was from the town of Villarondos, in the Peruvian Amazon, department of Huánuco, who accidentally knelt down on caterpillar bristles, and subsequently experienced hemolytic anemia, plateletopenia, and coagulation disorder. The diagnosis was made based on the medical history, clinical manifestation, laboratory examination results, and response to antilonomic serum. The clinical, laboratory, and therapeutic aspects of erucism due to Lonomia spp. are discussed.

Stinting larvae (Lepidoptera) associated with horticultural crops in Cerro Punta, Chiriquí, Panama

“…En pacientes con sensibilización previa o cruzada, generalmente aparece urticaria de contacto la cual puede presentar angioedema asociado hasta en el 50% de los casos. En otras latitudes se ha descrito la aparición de síntomas respiratorios y algunos casos de erucismo hemorrágico (Peña-Vásquez et al, 2016); sin embargo, estos no han sido descritos en Panamá y pueden depender de la especie. Como se describió previamente, solo un 18,2% de los encuestados acudió al médico, prefiriendo tratar el accidente con medidas tradicionales.…”

Multiple organ failure caused by poisonous contact with a Lonomia sp caterpillar. Case report

“…According to statistics, between 1989 and 2005, 354 cases were reported in Brazil, with a lethality that dropped from 20% in 1995 to 15% in 1998, being intracranial bleeding the cause of death in 50% of cases. (12) In Colombia, the incidence of lonomic accidents and knowledge of this pathology is low, making epidemiological notification difficult. According to the Colombian Toxicological Research, Management and Information Center, between 2006 and 2010, 68 cases of lepidopteran accidents occurred due to spontaneous and passive reporting, being the sixth cause of incidence of accidents by poisonous animals, with a relative frequency of 4% (Figure 4).…”

Effectiveness of Lonomia antivenom in recovery from the coagulopathy induced by Lonomia orientoandensis and Lonomia casanarensis caterpillars in rats

“…Diagnosis of envenomation by contact with Lonomia caterpillars is based on clinical signs and symptoms, and the hemorrhagic syndrome is based on consumption coagulopathy. In recent years, Argentina [ 17 , 18 ], Peru [ 20 , 34 ], and French Guiana [ 35 ] have reported accidents resulting from contact with Lonomia caterpillars, including fatalities. In Colombia, from 2005 to 2010, after an epidemiological surveillance protocol is established, the use of LAV was started, and since then, 32 cases have been reported, including two deaths[ 21 ].…”

“…obliqua and L . achelous [ 8 , 9 ], and in recent years, Argentina [ 17 – 19 ] and Peru [ 20 ] have also indicated an increasing number of accidents and fatalities.…”