Clinical effects of exposure to the White-stemmed gum moth (Chelepteryx collesi).
BACKGROUND
The White-stemmed gum moth (Chelepteryx collesi) can be found in eastern Australia. The clinical effects of injuries caused by its many spine-like hairs are poorly defined and concern about the numerous hairs that remain embedded following contact with the cocoon have led to heroic means of removal.


OBJECTIVE
To examine the clinical effects of injuries by the caterpillar or cocoon of the White-stemmed gum moth.


METHODS
Prospective observational study of caterpillar injuries from calls to the New South Wales Poisons Information Centre. Cases resulting from C. collesi exposure were included for analysis. Caterpillars and cocoons were expertly identified where available and a follow-up consultation of all patients was conducted. Information was collected on the circumstances of exposure, local and systemic effects and treatment.


RESULTS
From the 26 included cases, seven had confirmed caterpillar contact (all children aged 1-11), six had confirmed cocoon contact and 13 had exposures consistent with C. collesi, but no caterpillar was caught. All cases occurred in summer. Of 13 confirmed exposures there was no difference between caterpillars and cocoons, and these were considered together. Affected areas were hands, feet, or both, following C. collesi being handled or trodden on. Pain was reported in all 13 cases, one with severe pain. In 10 cases pain duration was < 60 min. Six subjects had more than 100 hairs embedded (small black dots). In three cases, the hairs were surrounded by swelling and yellow discolouration. Despite the attempted removal of multiple hairs, they remained embedded for prolonged periods but caused no sequelae.


CONCLUSIONS
The clinical effects of the White-stemmed gum moth were minor with local pain. Although hairs remained in all cases, they caused no problems. Complete removal of hairs is neither possible nor necessary, and painful and invasive methods should be avoided.
Balit
Corrine R
CR
NSW Poisons Information Centre, The Children's Hospital at Westmead, Australia. corrinebalit@aol.com
Geary
Merilyn J
MJ
Russell
Richard C
RC
Isbister
Geoffrey K
GK
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D001733:Bites and Stings / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003877:Dermatitis, Contact / Q000209:etiology; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D005528:Foot; D005547:Foreign Bodies / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D006225:Hand; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009036:Moths; D009517:New South Wales / Q000453:epidemiology; D010146:Pain / Q000209:etiology; D011039:Poison Control Centers; D011446:Prospective Studies; D012621:Seasons; D012720:Severity of Illness Index; D016896:Treatment Outcome