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Oropharyngeal manifestations of lepidopterism
D Lee1, R D Pitetti, M L Casselbrant
1Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, PA 15217, USA.
Objective:
To describe previously unreported oropharyngeal manifestations and management of caterpillar ingestion.
Design:
Retrospective case series.
Setting:
Tertiary children's hospital.
Patients:
A total of 733 cases of exposure to caterpillars from January 1, 1994, to November 1, 1997, were reviewed. Twenty-six patients had oropharyngeal exposure with 8 patients ingesting the caterpillar. Ages ranged from 7 months to 7 years with 14 boys and 12 girls.
Interventions:
All patients had a thorough examination of the oropharynx for caterpillar spines. For children who ingested a caterpillar, direct laryngoscopy, bronchoscopy, and esophagoscopy with removal of caterpillar spines were performed.
Results:
At the point of caterpillar contact, buried caterpillar spines with focal erythema were observed. The lips, tongue, and buccal mucosa were the most frequently involved areas. The esophagus was involved in 8 of the patients. No postoperative complications were noted.
Conclusion:
With individualized care and prompt removal of venomous caterpillar spines, complications are not likely to result from caterpillar ingestion.