What is the treatment for a centipede bite?

Treatment for Centipede Bites

For centipede bites, treatment should focus on pain management with over-the-counter medications like acetaminophen or NSAIDs, application of ice, and topical lidocaine if available. While there are no specific guidelines for centipede bites, management principles can be extrapolated from guidelines for similar envenomations 1.

Initial Assessment and Management

• Assess for systemic symptoms: Call emergency services if the patient develops systemic symptoms such as difficulty breathing, muscle rigidity, dizziness, or confusion 1
• Pain management options:
  • Apply ice to the bite site for local pain relief 1
  • Use over-the-counter acetaminophen or NSAIDs for pain control 1
  • Apply topical lidocaine (if skin is intact) to relieve local pain 1
• Hot water immersion: Some evidence suggests immersing the bite area in hot water may provide pain relief 2
• Wound care: Clean the bite site with soap and water to prevent infection

When to Seek Medical Care

Medical attention should be sought if:

• Pain extends beyond the bite site or becomes severe and uncontrolled by over-the-counter pain medications 1
• An open wound develops at the bite site 1
• Systemic symptoms develop (difficulty breathing, muscle rigidity, dizziness, confusion) 1

What to Avoid

• Antibiotic prophylaxis: Evidence suggests that routine antibiotic prophylaxis is unnecessary for centipede bites 3
• Tourniquets or pressure immobilization: These are not recommended for arthropod bites 1

Potential Complications

• Local reactions: Most centipede bites cause only local effects including pain, redness, and swelling 2
• Rare complications: In rare cases, bacterial superinfection can lead to cellulitis or necrotizing fasciitis 4
• Delayed reactions: Some patients may experience delayed pruritus or recurrent swelling 5

Special Considerations

• Patients with underlying conditions: Those with sickle cell trait may experience more severe and prolonged symptoms 6
• Bite location: Bites frequently occur on lower limbs, often at night and indoors 5

Most centipede bites have a favorable outcome with symptomatic treatment alone. The pain, while potentially severe, typically resolves with appropriate pain management measures and supportive care.