What is the treatment for cantharidin poisoning from blister beetle exposure?

From the Guidelines

To treat cantharidin poisoning from blister beetle exposure, immediately wash the affected area with soap and water to remove any remaining toxin and seek medical attention if severe symptoms occur, as cantharidin is highly toxic when taken systemically 1. When treating cantharidin poisoning, it is essential to prioritize supportive care, including airway management, hemodynamic support, and correction of critical vital sign and metabolic derangements, as timely and effective supportive care is crucial to the care of the poisoned patient 1.

Key Treatment Steps:

• Wash the affected area with soap and water to remove any remaining toxin
• Apply cold compresses to reduce pain and swelling
• For pain relief, take over-the-counter medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours)
• Avoid breaking any blisters that form, as this can lead to infection
• Apply an antibiotic ointment like bacitracin or neosporin to the affected area 2-3 times daily and cover with a clean bandage

Important Considerations:

• Cantharidin is highly toxic when taken systemically, and ingestion can cause serious damage to the digestive and urinary tracts 1
• Medical professionals may provide additional treatments, including stronger pain medications, specialized wound care, or systemic treatments, depending on the severity of exposure
• In cases of severe symptoms, such as extensive blistering, difficulty breathing, fever, or ingestion of the blister beetle, seek immediate medical attention 1

From the Research

Treatment for Cantharidin Poisoning

The treatment for cantharidin poisoning from blister beetle exposure is primarily supportive, as there is no antidote available 2, 3, 4.

• Supportive measures include:
  • Intravenous fluid therapy to manage symptoms such as abdominal pain, dysuria, and renal insufficiency 2
  • Management of gastrointestinal and genitourinary mucosal irritation, as well as renal dysfunction 2, 3
  • Monitoring of laboratory parameters, such as electrolyte levels and renal function, to ensure they return to normal 2
• Conservative management is also recommended, as seen in cases where patients ingested blister beetles or preparations containing cantharidin 3, 5

Clinical Presentations

Cantharidin poisoning can result in a range of clinical presentations, including:

• Gastrointestinal symptoms, such as abdominal pain, diarrhea, and hematemesis 3, 6
• Genitourinary symptoms, such as dysuria, hematuria, and renal impairment 2, 3, 6
• Other symptoms, such as fever, hypotension, and atypical neurological symptoms 2, 3