title: Severe Hemorrhagic Syndrome After Lonomia Caterpillar Envenomation in the Western Brazilian Amazon: How Many More Cases Are There?
abstract: Contact with Lonomia caterpillars can cause a hemorrhagic syndrome. In Brazil, Lonomia obliqua and Lonomia achelous are known to cause this venom-induced disease. In the Brazilian Amazon, descriptions of this kind of envenomation are scarce. Herein, we report a severe hemorrhagic syndrome caused by Lonomia envenomation in the Amazonas state, Western Brazilian Amazon. The patient showed signs of hemorrhage lasting 8 days and required Lonomia antivenom administration, which resulted in resolution of hemorrhagic syndrome. Thus, availability of Lonomia antivenom as well as early antivenom therapy administration should be addressed across remote areas in the Amazon.
authors.affiliation: Directorate of Education and Research, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil (Drs Santos, Mendonça-da-Silva, Tavares, Ferreira, Lacerda, and Monteiro).
authors.forename: João Hugo A
authors.initials: JHA
authors.lastname: Santos
authors.affiliation: School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil (Ms Oliveira, Alves, and Sachett, and Drs Mendonça-da-Silva and Monteiro).
authors.forename: Sâmella S
authors.initials: SS
authors.lastname: Oliveira
authors.affiliation: School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil (Ms Oliveira, Alves, and Sachett, and Drs Mendonça-da-Silva and Monteiro).
authors.forename: Eliane C
authors.initials: EC
authors.lastname: Alves
authors.affiliation: School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil (Ms Oliveira, Alves, and Sachett, and Drs Mendonça-da-Silva and Monteiro).
authors.forename: Iran
authors.initials: I
authors.lastname: Mendonça-da-Silva
authors.affiliation: School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil (Ms Oliveira, Alves, and Sachett, and Drs Mendonça-da-Silva and Monteiro).
authors.forename: Jacqueline A G
authors.initials: JAG
authors.lastname: Sachett
authors.affiliation: Directorate of Education and Research, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil (Drs Santos, Mendonça-da-Silva, Tavares, Ferreira, Lacerda, and Monteiro).
authors.forename: Antonio
authors.initials: A
authors.lastname: Tavares
authors.affiliation: Directorate of Education and Research, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil (Drs Santos, Mendonça-da-Silva, Tavares, Ferreira, Lacerda, and Monteiro).
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Ferreira
authors.affiliation: Venoms and Antivenoms Strategic Board, Instituto Butantan, São Paulo, Brazil (Dr Fan).
authors.forename: Hui Wen
authors.initials: HW
authors.lastname: Fan
authors.affiliation: Leônidas & Maria Deane Research Institute, Fundação Oswaldo Cruz, Manaus, Brazil (Dr Lacerda).
authors.forename: Marcus V G
authors.initials: MVG
authors.lastname: Lacerda
authors.affiliation: School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil (Ms Oliveira, Alves, and Sachett, and Drs Mendonça-da-Silva and Monteiro). Electronic address: wueltonmm@gmail.com.
authors.forename: Wuelton M
authors.initials: WM
authors.lastname: Monteiro
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D001938:Brazil; D006470:Hemorrhage / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D007299:Insect Bites and Stings / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009036:Moths; D013577:Syndrome
chemical_list: D000997:Antivenins
keywords: Lonomia; antivenom; caterpillar envenomation; erucism; hemorrhagic syndrome