Epidural Hematoma Secondary to Severe Coagulopathy after Lonomia Obliqua Contact: Anti-lonomic Antidote-Serum Efficacy Proven

Roman A, Anzolin E, Ramos CO,

Abstract

In the present study, we report a case of a 2.5 old female child patient who came in contact with the bristles of the caterpillar Lonomia obliqua (local named Taturana), presenting a severe coagulation disorder and hemorrhagic syndrome, with mucosa bleeding and posterior decrease in level of consciousness, secondary to a massive epidural hematoma. The patient received two doses of antilonomic serum antidote, red blood cell concentrate, mannitol and was taken to surgical evacuation of the hematoma, progressing with necessity of ICU treatment, with posterior clinical improvement, and lastly hospital discharge. It is known that Lonomia obliqua venom activates prothrombin and factor X, promoting fibrinogenic lytic activity, and the use of the specific antidote anti-lonomic serum has demonstrated to cease the coagulation disorder and allow clinical improvement and invasive procedures in specific cases, as in the one presented.

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