Wilderness & environmental medicine
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Wilderness Environ Med · Jan 1998
Case Reports"Puss caterpillar" envenomation: a report from North Carolina.
A 41-year-old white man with no specific past medical history presented to the Emergency Department on October 13, 1997, following what he described as a "caterpillar bite." The insect was subsequently identified as a "puss caterpillar" (Megalopyge opercularis). The patient experienced immediate excruciating pain that radiated throughout his left arm and gradually spread to the left chest area. ⋯ The patient was subsequently admitted for observation and released several days later. Viewed in the context of previous clinical reports, this case highlights the broad range of clinical symptoms that can result from the puss caterpillar sting.
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Wilderness Environ Med · Nov 1997
ReviewWidow spider envenomation (latrodectism): a worldwide problem.
The objective of this study was to review widow spider envenomation on a worldwide basis, with an emphasis on regional variability in management, particularly between the United States and Australia. Data sources were the Medline database (1966-1997) for English language references using as key words widow spider, latrodectism, and red back spider, and Mesh headings. Textbooks of toxinology were also used. ⋯ The literature suggests that antivenin to one species of Latrodectus is likely to be effective against other species. The conclusion drawn was that latrodectism is a common envenomation worldwide. There is a strong case for a comparative trial of Australian vs US antivenin in treating latrodectism due to the black widow spider in the United States.
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Wilderness Environ Med · Nov 1997
ReviewPrimary amebic meningoencephalitis: a review of the clinical literature.
Primary amebic meningoencephalitis (PAM) is a rapidly progressive and potentially fatal infection frequently contracted by swimming in bodies of warm fresh water. The etiological agent in most reported cases of PAM is the ameboflagellate Naegleria fowleri. ⋯ Physicians treating individuals who present with an acute pyogenic meningitis should consider the diagnosis of PAM, particularly if the patient has a recent history of swimming in warm fresh water. We review the recent literature for cases of PAM and the discuss ecology of N. fowleri and the clinical presentation, diagnosis, and treatment of PAM.
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We present a case report of cutaneous myiasis in a foreign traveler who was infected by Dermatobia hominis while visiting South America. This patient developed a painful furuncular lesion on the anterior scalp and noted that the lesion drained a serosanguinous fluid for more than a month before definitive treatment. ⋯ In addition to the case report, we present a discussion of furuncular myiasis and describe the peculiar life cycle of the human botfly. We also describe the various therapies that may be employed for treating cutaneous myiasis, including surgical extraction of the larva and asphyxiation of the larva by application of petroleum jelly or other fat derivatives to the central stoma or breathing aperture.