Giant Vietnamese Centipede Envenomation with Persistent Toxicologic Sequelae

Centipedes are among the largest terrestrial arthropods. Modified walking appendages called forcipules are connected to venom glands and used for predation and defense. Centipede envenomations in humans are relatively rarely reported; however, they can produce clinically significant effects. Most clinical cases are attributed to the genus Scolopendra. Scolopendra dehaani (S. dehaani), the giant Vietnamese centipede, is the largest of the Asian centipedes. A paucity of clinical literature exists on envenomation by S. dehaani, originally considered a subspecies of Scolopendra subspinipes but now identified as an independent species. A 55-year-old man was envenomated on his left index finger by S. dehaani and reported excruciating pain with progressive erythema and edema. He required multiple doses of opioids and a parenteral antihistamine with gradual, yet incomplete, symptom improvement. The centipede was morphologically identified as S. dehaani. Three months post-envenomation, the patient reported residual numbness and swelling and a relatively limited range of motion in the affected finger.