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Arizona. Test for sensitivity to the serum only if the antivenin is to be used. Administer
tetanus immunization.
D. Centipede Bites: Centipedes are found all over the United States. They rarely cause
serious injury to humans. The giant desert centipede, which may attain a length of 15 cm
(6 inches), can give a painful bite. Most bite reactions are local and no fatalities have
been documented, but renal failure has been reported. Generally, centipedes hide in dark
places. Check shoes, clothing, and bedding before use while traveling in centipede-
infested areas.
Local reactions to centipede bites, in addition to intense pain, may include edema
and erythema, lasting 4 to 12 hours. In severe bites, tenderness may persist or recur. To
prevent secondary infection, cleanse the wound with soap and water. Apply cold and/or
give oral analgesics for pain. In more serious reactions, where there is local lymphangitis,
evidence of local necrosis at the bite site, or the rare systemic reaction, evacuate the
patient. In case there is severe pain, infiltrate locally with lidocaine
For centipede bites, observe patients with minor reactions for approximately four
hours, or until the reaction improves. Admit patients with evidence of significant reaction
because of potential rhabdomyolysis and acute renal failure. Tetanus prophylaxis should
be current.
Millipedes do not bite, but they may have secretions that irritate the skin. Treat by
washing with soap and water (not alcohol) and applying a corticosteroid cream or lotion.
E. Because of the possibility of contaminated skin, tetanus immunization should be
current for all bites and stings, regardless of species inflicting the injury.
