PRESENTATION OF A CASE OF ACCIDENT WITH OBLIQUE LONOMIA AND ACUTE KIDNEY INJURY.

Resumo

INTRODUCTION: Accidents with caterpillars of the genus Lonomia are rare, but their relevance is significant due to the ability of this accident to trigger serious health conditions, such as hemorrhagic syndrome and acute kidney injury. After cutaneous contact of the caterpillar's bristles with human skin, hemorrhagic toxins are released. Symptoms begin locally, such as urticating dermatitis, pain, and edema in the region of contact with the caterpillar's bristles. Then, hematomas, ecchymosis, hemorrhages in mucous cavities, hematuria, and melena may appear. More serious complications, such as intracerebral hemorrhage and acute kidney failure, may also occur. According to DATASUS, accidents caused by caterpillars were reported in 3,023 Brazilian municipalities between 2019 and 2023. In turn, accidents caused by Lonomia were reported in 1,380 municipalities in the same period. Primary treatment consists of administering antilonomia serum depending on the severity of the case, consisting of immunoglobulins from plasma of horses immunized with extract of Lonomia Obliqua bristles, aiming to reduce complications and deaths. CASE REPORT: A.L., 78 years old, had contact with an unknown caterpillar in an individual accident 4 days ago. He started with anal and gum bleeding, epistaxis, bruising and hematuria one day after contact with the animal. Laboratory tests were requested to confirm contact with a possible caterpillar. The tests performed showed significant alterations: hemoglobin 11.5, leukocytes 5900, platelets 29 thousand, urea 286, creatinine 11.6, prothrombin time 12.5 atv 63.8% INR 1.25 corroborating the hypothesis of an accident with Lonomia. The patient received ten ampoules of Antilonomic Serum (SALon), had good clinical and laboratory evolution and, after five days, was discharged from the health unit with improvement. DISCUSSION: Accidents with caterpillars of the genus Lonomia, although rare, are considerably serious due to their potential to cause hemorrhagic events and acute renal failure. In recent years, there has been an increase in reports of accidents caused by caterpillars in Brazil. Considering that caterpillars of the genus Lonomia have the potential to cause serious accidents, their area of ​​occurrence is expanding. Due to their potential to cause serious cases and even deaths, it is important that the health sector be prepared to meet the growing demand for cases, leaving antilonomia serum in strategic areas with a high incidence of confirmed cases.