Envenomation by Caterpillars

  • Isadora Maria Villas-Boas
  • Miryam Paola Alvarez-Flores
  • Ana Marisa Chudzinski-Tavassi
  • Denise V. Tambourgi
Reference work entry
Part of the Toxinology book series (TOXI)


In recent years, injuries resulting from human contact with Lepidoptera species have become an increasing health problem in different regions around the world, occasionally with epidemic features. The majority of medically significant contacts with Lepidoptera occur with exposure to the larva form. Adverse effects are often treated with antipruritic and oral antihistamines. In the case of South American Lonomia obliqua caterpillar, however, it was necessary to develop a specific antivenom to neutralize the severe coagulation disorders in patients. Toxic principles related to the envenoming are found in setae secretion and hemolymph in larvae (erucism) and, in a few cases, in urticant hairs in adult moths (lepidopterism). These compounds are responsible for many toxic or allergic reactions in different organisms, such as local pain, inflammation, itching, irritation, and, in more severe cases, deforming arthritis, consumption coagulopathy, and hemorrhage. Despite clear documentation of adverse reaction in humans due to some species of Lepidoptera, very few studies were carried out as an attempt to understand the pathophysiological mechanism of the envenoming and toxins involved. This chapter reviews currently available information about Lepidoptera’s toxic species and relates, when possible, its properties with clinical data that have been described so far.


Caterpillars Toxins Urticating dermatitis Consumption coagulopathy Deforming arthritis 


  1. Alvarez Flores MP, Fritzen M, Reis CV, Chudzinski-Tavassi AM. Losac, a factor X activator from Lonomia obliqua bristle extract: its role in the pathophysiological mechanisms and cell survival. Biochem Biophys Res Commun. 2006;343(4):1216–23.CrossRefPubMedGoogle Scholar
  2. Alvarez Flores MP, Zannin M, Chudzinski-Tavassi AM. New insight into the mechanism of Lonomia obliqua envenoming: toxin involvement and molecular approach. Pathophysiol Haemost Thromb. 2010;37(1):1–16.CrossRefPubMedGoogle Scholar
  3. Arocha-Pinango CL, Marval E, Guerrero B. Lonomia genus caterpillar toxins: biochemical aspects. Biochimie. 2000;82(9–10):937–42.CrossRefPubMedGoogle Scholar
  4. Arocha-Pinango CL, Guerrero BA, Lucena S, Gorzula S. Epidemiología clínica y terapéutica del envenenamiento por orugas. La experiencia venezolana. In: D’Suze G, Corzo Burguete GA, Paniagua Solís JF, editors. Emergencias por animales ponzoñosos en las Américas. Mexico: Instituto Bioclón, SA de CV & Laboratorios Silanes, SA de CV; 2011. p. 287–302.Google Scholar
  5. Balit CR, Ptolemy HC, Geary MJ, Russell RC, Isbister GK. Outbreak of caterpillar dermatitis caused by airborne hairs of the mistletoe browntail moth (Euproctis edwardsi). Med J Aust. 2001;175(11–12):641–3.PubMedGoogle Scholar
  6. Balit CR, Geary MJ, Russell RC, Isbister GK. Prospective study of definite caterpillar exposures. Toxicon. 2003;42(6):657–62.CrossRefPubMedGoogle Scholar
  7. Balit CR, Geary MJ, Russell RC, Isbister GK. Clinical effects of exposure to the White-stemmed gum moth (Chelepteryx collesi). Emerg Med Australas. 2004;16(1):74–81.CrossRefPubMedGoogle Scholar
  8. Benvenuti LA, Cardoso JL, Moraes RH. Cutaneous leucocytoclastic vasculitis from contact with Hylesia moths (Lepidoptera: Saturniidae). Trans R Soc Trop Med Hyg. 1998;92(4):428–9.CrossRefPubMedGoogle Scholar
  9. Bisset GW, Frazer JF, Rothschild M, Schachter M. A pharmacologically active choline ester and other substances in the garden tiger moth, Arctia caja (L.). Proc R Soc London Ser B. 1960;152:255–62.CrossRefGoogle Scholar
  10. Bleumink E, de Jong MC, Kawamoto F, Meyer GT, Kloosterhuis AJ, Slijper-Pal IJ. Protease activities in the spicule venom of Euproctis caterpillars. Toxicon. 1982;20(3):607–13.CrossRefPubMedGoogle Scholar
  11. Cardoso AEC, Haddad JV. Accidents caused by lepidopterans (moth larvae and adult): study on the epidemiological, clinical and therapeutic aspects. An Bras Dermatol. 2005;80(6):571–8.CrossRefGoogle Scholar
  12. Chudzinski-Tavassi AM, Alvarez-Flores MP. South American Lonomia obliqua caterpillars: morphologic aspects and venom biochemistry. In: Guerritore E, DeSare J, editors. Lepidoptera. New York: Nova Science Publishers; 2013.Google Scholar
  13. Costa RM. Pararamose. In: Cardoso JLC, Wen FH, França FOS, Malaque CMS, editors. Animais peçonhentos no Brasil: biologia, clínica e terapêutica dos acidentes. São Paulo: Sanvier; 2003. p. 233–6.Google Scholar
  14. Costa RM, Silva NP, Teves DC, Costa ML, Ferraz MB, Atra E. Experimental arthritis induced by bristles from a “Lepidoptera”, “Premolis semirufa”: histopathological study in rats. Rev Bras Reumatol. 1995;35(2):61–4.Google Scholar
  15. Da Silva WD, Campos CM, Goncalves LR, et al. Development of an antivenom against toxins of Lonomia obliqua caterpillars. Toxicon. 1996;34(9):1045–9.CrossRefPubMedGoogle Scholar
  16. De Jong MC, Kawamoto F, Bleumink E, Kloosterhuis AJ, Meijer GT. A comparative study of the spicule venom of Euproctis caterpillars. Toxicon. 1982;20(2):477–85.CrossRefPubMedGoogle Scholar
  17. Diaz JH. The evolving global epidemiology, syndromic classification, management, and prevention of caterpillar envenoming. Am J Trop Med Hyg. 2005;72(3):347–57.PubMedGoogle Scholar
  18. Dinehart SM, Jorizzo JL, Soter NA, et al. Evidence for histamine in the urticating hairs of Hylesia moths. J Invest Dermatol. 1987;88(6):691–3.CrossRefPubMedGoogle Scholar
  19. Espindula AP, Ferraz ML, Ferreira AA, Faleiros ACG, Oliveira FA, Teixeira VPA. Human accident with lepidopterans. Revista de Patologia Tropical. 2009;38(1):63–6.Google Scholar
  20. Frazer JFD. The cause of urtication produced by larval hairs of Arctia caja (L.) (Lepidoptera: Arctiidae). Proc R Entomol Soc London Ser A Gen Entomol. 1965;40(7–9):96–100.Google Scholar
  21. Gullan PJ, Cranston P. The insect: an outline of entomology. 3rd ed. Malden: Wiley-Blackwell; 2005.Google Scholar
  22. Henwood BP, MacDonald DM. Caterpillar dermatitis. Clin Exp Dermatol. 1983;8(1):77–93.CrossRefPubMedGoogle Scholar
  23. Horng CT, Chou PI, Liang JB. Caterpillar setae in the deep cornea and anterior chamber. Am J Ophthalmol. 2000;129(3):384–5.CrossRefPubMedGoogle Scholar
  24. Hossler EW. Caterpillars and moths. Dermatol Ther. 2009;22(4):353–66.CrossRefPubMedGoogle Scholar
  25. Hossler EW. Caterpillars and moths: part I. Dermatologic manifestations of encounters with Lepidoptera. J Am Acad Dermatol. 2010a;62(1):1–10. quiz 1–2.CrossRefPubMedGoogle Scholar
  26. Hossler EW. Caterpillars and moths: part II. Dermatologic manifestations of encounters with Lepidoptera. J Am Acad Dermatol. 2010b;62(1):13–28. quiz 9–30.CrossRefPubMedGoogle Scholar
  27. Huang DZ. Dendrolimiasis: an analysis of 58 cases. J Trop Med Hyg. 1991;94(2):79–87.PubMedGoogle Scholar
  28. Kawamoto F, Kumada N. Biology and venoms of lepitdoptera. In: Tu AT, editor. Insect poisons, allergens and other invertebrate venoms. New York: Marcel Dekker; 1984.Google Scholar
  29. Kuspis DA, Rawlins JE, Krenzelok EP. Human exposures to stinging caterpillar: Lophocampa caryae exposures. Am J Emerg Med. 2001;19(5):396–8.CrossRefPubMedGoogle Scholar
  30. Lamdin JM, Howell DE, Kocan KM, et al. The venomous hair structure, venom and life cycle of Lagoa crispata, a puss caterpillar of Oklahoma. Toxicon. 2000;38(9):1163–89.CrossRefPubMedGoogle Scholar
  31. Lawson JP, Liu YM. Pinemoth caterpillar disease. Skeletal Radiol. 1986;15(6):422–7.CrossRefPubMedGoogle Scholar
  32. Lee D, Pitetti RD, Casselbrant ML. Oropharyngeal manifestations of lepidopterism. Arch Otolaryngol Head Neck Surg. 1999;125(1):50–2.CrossRefPubMedGoogle Scholar
  33. Moneo I, Vega JM, Caballero ML, Vega J, Alday E. Isolation and characterization of Tha p 1, a major allergen from the pine processionary caterpillar Thaumetopoea pityocampa. Allergy. 2003;58(1):34–7.CrossRefPubMedGoogle Scholar
  34. Mullen GR. Moths and butterflies (Lepidoptera). In: Mullen GR, Durden LA, editors. Medical and veterinary entomology. San Diego: Academic; 2002. p. 364.Google Scholar
  35. Pinson RT, Morgan JA. Envenomation by the puss caterpillar (Megalopyge opercularis). Ann Emerg Med. 1991;20(5):562–4.CrossRefPubMedGoogle Scholar
  36. Reis CV, Portaro FC, Andrade SA, et al. A prothrombin activator serine protease from the Lonomia obliqua caterpillar venom (Lopap) biochemical characterization. Thromb Res. 2001a;102(5):427–36.CrossRefPubMedGoogle Scholar
  37. Reis CV, Farsky SH, Fernandes BL, et al. In vivo characterization of Lopap, a prothrombin activator serine protease from the Lonomia obliqua caterpillar venom. Thromb Res. 2001b;102(5):437–43.CrossRefPubMedGoogle Scholar
  38. Rodriguez-Mahillo AI, Gonzalez-Munoz M, Vega JM, et al. Setae from the pine processionary moth (Thaumetopoea pityocampa) contain several relevant allergens. Contact Dermatitis. 2012;67(6):367–74.CrossRefPubMedGoogle Scholar
  39. Saúde. BMd. Manual de diagnóstico e tratamento de acidentes por animais peçonhentos. Brasilia: Fundação Nacional de Saúde (FUNASA); 1992.Google Scholar
  40. Sengupta S, Reddy PR, Gyatsho J, Ravindran RD, Thiruvengadakrishnan K, Vaidee V. Risk factors for intraocular penetration of caterpillar hair in Ophthalmia Nodosa: a retrospective analysis. Indian J Ophthalmol. 2010;58(6):540–3.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Shibui H, Kawashima H, Kamata K, Sasaki H, Inoda S, Shimizu H. Vitrectomy for caterpillar seta-induced endophthalmitis. Arch Ophthalmol. 1997;115(4):555–6.CrossRefPubMedGoogle Scholar
  42. Tripi PA, Lee R, Keiper JB, Jones AW, Arnold JE. An unusual case of ingestion of a moth cocoon in a 14-month-old girl. Am J Otolaryngol. 2010;31(2):123–6.CrossRefPubMedGoogle Scholar
  43. Valle JR, Picarelli ZP, Prado JL. Histamine content and pharmacological properties of crude extracts from setae of urticating caterpillars. Arch Int Pharmacodyn Ther. 1954;98(3):324–34.PubMedGoogle Scholar
  44. Van Nieukerken EJ, Kaila L, Kitching IJ, et al. Order Lepidoptera Linnaeus, 1758. In: Zhang Z-Q, editor. Animal biodiversity: an outline of higher-level classification and survey of taxonomic richness. Auckland: Magnolia Press; 2011. p. 212–21.Google Scholar
  45. Vega J, Vega JM, Moneo I. Skin reactions on exposure to the pine processionary caterpillar (Thaumetopoea pityocampa). Actas Dermosifiliogr. 2011;102(9):658–67.CrossRefPubMedGoogle Scholar
  46. Villas-Boas IM, Goncalves-de-Andrade RM, Pidde-Queiroz G, et al. Premolis semirufa (Walker, 1856) envenomation, disease affecting rubber tappers of the Amazon: searching for caterpillar-bristles toxic components. PLoS Negl Trop Dis. 2012;6(2), e1531.CrossRefPubMedPubMedCentralGoogle Scholar
  47. Villas Boas IM, Pidde-Queiroz G, Magnoli FC, Goncalves-de-Andrade RM, van den Berg CW, Tambourgi DV. A serine protease isolated from the bristles of the Amazonic caterpillar, Premolis semirufa, is a potent complement system activator. PLoS One. 2015;10(3), e0118615.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Villas-Boas IM, Goncalves-de-Andrade RM, Squaiella-Baptistao CC, Sant'Anna OA, Tambourgi DV. Characterization of phenotypes of immune cells and cytokines associated with chronic exposure to Premolis semirufa caterpillar bristles extract. PLoS One. 2013;8(9), e71938.CrossRefPubMedPubMedCentralGoogle Scholar
  49. Zannin M, Lourenco DM, Motta G, et al. Blood coagulation and fibrinolytic factors in 105 patients with hemorrhagic syndrome caused by accidental contact with Lonomia obliqua caterpillar in Santa Catarina, southern Brazil. Thromb Haemost. 2003;89(2):355–64.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Isadora Maria Villas-Boas
    • 1
  • Miryam Paola Alvarez-Flores
    • 2
  • Ana Marisa Chudzinski-Tavassi
    • 2
  • Denise V. Tambourgi
    • 3
  1. 1.Immunochemistry LaboratoryButantan InstituteSão PauloBrazil
  2. 2.Biochemistry LaboratoryButantan InstituteSão PauloBrazil
  3. 3.Laboratory of ImmunochemistryDivision of Development and Innovation, Butantan InstituteSão PauloBrazil

Personalised recommendations