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Dennis Lee, MD; Raymond D. Pitetti, MD; Margaretha L. Casselbrant, MD, PhD

Arch Otolaryngol Head Neck Surg. 1999;125:50-52.

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.

From the Departments of Pediatric Otolaryngology (Drs Lee and Casselbrant) and Emergency Medicine (Dr Pitetti), Children's Hospital of Pittsburgh, Pittsburgh, Pa.