What is Centipede Envenomation (Centipede Venom)?
Centipedes are venomous creatures that hunt their prey. They have bodies made up of 15 to nearly 200 segments, each with a pair of legs. Their fangs, known as forcipules, are actually modified legs that contain venom. Centipedes have a long history, with the oldest fossils resembling today’s species dating back over 400 million years. Over time, they’ve become very skilled hunters, primarily eating other small creatures, but some can attack and even kill small mammals, bats, and amphibians!
There are about 3500 different types of centipedes, but only 15 of them, less than 0.5%, cause serious harm or discomfort to humans. It’s hard to know how often centipede bites happen, as most aren’t serious enough to need medical attention because many centipedes are too small to cause significant harm. Still, centipede bites are important to note, because their venom contains a mix of toxins and can result in severe pain and other significant side effects. In this discussion, we will cover some key points about identifying and treating centipede bites.
What Causes Centipede Envenomation (Centipede Venom)?
Centipedes are creatures that are generally active during the night and like to live in warm, damp climates. That’s why people usually report being bitten by centipedes on summer nights more often. The most frequent bite locations are the hands and feet.
Bites on the feet usually happen because centipedes have a tendency to hide in shoes or because people step on them barefoot. Hand bites are more common amongst children or individuals who try to pick up a centipede.
Risk Factors and Frequency for Centipede Envenomation (Centipede Venom)
Centipedes can be found everywhere in the world, except Antarctica. This includes all 50 states in the United States, although they’re more often seen in warmer climates like the southern states and particularly Hawaii. Despite being quite effective hunters, centipede bites are rare due to their shy, nocturnal behavior and the fact that most centipedes are too small to cause serious harm to humans.
Most recorded bites come from the Scolopendra family, the largest known types of centipedes, which can grow up to 12 inches. The large size likely means they have more venom, which can explain why their bites can lead to more serious symptoms.
Between the years 1979 and 2001, there were only 6 reported deaths in the USA due to centipede bites, while over 1,000 people died from bee, wasp, and hornet stings. In cases where centipede bites caused death, the exact ways in which the venom caused the fatality weren’t determined. However, there have been three well-documented cases:
- A person was bitten in the back of the throat, causing swelling and suffocation.
- An individual died from anaphylaxis, a severe allergic reaction, after a bite.
- A child was bitten on the scalp leading to death.
While these deaths are rare, centipede bites can still produce severe pain and complications.
Signs and Symptoms of Centipede Envenomation (Centipede Venom)
If you are bitten by a centipede, there are some important things that the doctor will need to know and consider. They will first ask a few questions to confirm that it was indeed a centipede bite. It will be helpful if you could describe the creature that bit you as clearly as possible. It’s also important to remember when exactly you were bitten as this will help the doctor monitor you for further symptoms.
Your size compared to the size of the centipede is also a factor. While centipede venom is powerful and dangerous, humans are generally much larger than the insects that centipedes usually prey upon, which helps protect us. However, this size difference doesn’t provide as much protection for infants and young children.
The doctor will also need to know about any allergies or health conditions you have, as these might direct their attention to certain symptoms. They also need to know your up-to-date status with tetanus immunization. Lastly, they’ll ask you about any symptoms that don’t involve the skin.
When it comes to examining the actual bite, they’re looking for two bite marks, which is typical of centipedes. They’ll also check for redness, bruising, and swelling around the area of the bite. Depending to your symptoms, they might also check for non-skin-related symptoms, such as problems with your nervous system or chest pain.
Testing for Centipede Envenomation (Centipede Venom)
If someone gets bitten by a centipede and it seems to be a simple case, the primary treatment is to just take care of the wound on site. It’s also important to keep an eye out for more severe symptoms across the body. If the person who was bitten complains of symptoms like chest pain, tests for heart troubles, including troponins and EKG, should be done straight away. However, you don’t usually need imaging like x-rays or CT scans for an acute centipede bite.
Treatment Options for Centipede Envenomation (Centipede Venom)
Treating minor centipede bites is usually simple and involves several steps:
1. Cleaning the bite area with water to lower the chance of infection.
2. Applying cold packs to the bite. The cold can help numb the pain, slow nerve signaling and constrict blood vessels to reduce swelling.
3. Some people find relief from soaking the bitten body part in hot water, which may neutralize some heat-sensitive toxins in the venom. However, keep in mind that hot water may also increase pain for some individuals.
4. Painkillers, both local and systemic, are also advised. Applying a local anesthetic like lidocaine to the bite site can provide significant pain relief.
5. If the person hasn’t had a tetanus shot in the last 5 years, it should be updated.
6. Depending on the individual case, additional treatments such as antihistamines, corticosteroids, and medicine to relieve anxiety may be helpful.
Antibiotics are usually not necessary to prevent infection if the wound is properly cared for.
There’s no specific antidote for centipede venom. If the person develops severe symptoms, the treatment will focus on managing those specific symptoms. For instance, severe allergic reactions would be treated with epinephrine in the same way as allergen-induced allergic reactions. If chest pain suggests a heart attack, standard treatments like aspirin and procedures to open blocked arteries would apply. Delayed effects such as skin infections or localized tissue death may require antibiotics and wound cleaning.
What else can Centipede Envenomation (Centipede Venom) be?
Possible reasons for skin redness or swelling could include:
- Spider bite
- Insect bite
- Scorpion sting
- Skin infections, such as Cellulitis
What to expect with Centipede Envenomation (Centipede Venom)
In general, the outlook after a centipede bite is very good. Pain management is typically successful with the right pain relief measures. System-wide symptoms and even complications at the site of the bite are uncommon.
Possible Complications When Diagnosed with Centipede Envenomation (Centipede Venom)
A centipede bite can lead to several complications such as:
- Skin infection (cellulitis) or abscesses
- Tissue death in the local area (local necrosis)
- Insufficient blood supply to the heart (myocardial ischemia)
- Breakdown of muscle tissue that can lead to kidney damage (rhabdomyolysis)
- A severe, potentially life-threatening allergic reaction (anaphylaxis)
