Misdiagnosed centipede and scorpion poisoning characterized by delayed hypersensitivity reaction: A case report

Traditional Chinese medicine is widely used in China and Asian countries. According to the traditional Chinese medicine theory, centipedes and scorpions have the functions of relaxing spasm, eliminating masses, relieving pain, and dredging meridians and collaterals. Improper medication can lead to serious adverse reactions. PATIENT CONCERNS: One 38-years-old female presented to our hospital because of cough and fever for more than 10 days. Ineffective anti-infection treatment, delayed skin rashes and supplementary medical history guided us to take centipede and scorpion poisoning into consideration. DIAGNOSES: Delayed hypersensitivity caused by centipedes and scorpions. INTERVENTIONS: Anti-allergic therapy with glucocorticoid (methylprednisolone 40 mg/day) and H1 receptor antagonists (loratadine 10 mg/day). OUTCOMES: During the 1 year follow-up revealed, no fever, rash and any discomfort occurred. LESSONS: This case suggests that because oral Chinese medicine poisoning is rare, detailed collection of medical history is particularly important for poisoning diagnosis.