The pine processionary caterpillar, Thaumetopoea pityocampa, is considered an emerging pine pest in Mediterranean countries, with high medical relevance. In recent years, adverse reactions reports in humans following contact with T. pityocampa have been increasingly reported.
If this caterpillar comes in contact with skin, it can cause a variety of reactions, notably contact urticaria and papular rashes. However, other reactions have been reported, including several cases of anaphylactic reactions.
Mechanical (irritative) mechanisms may be involved in the pathogenesis of lesions, as well as immunoglobulin E-mediated allergic hypersensitivity reactions that may be implicated when the process is rapid, recurrent, and progressively more severe.
Here we describe two pediatric cases following exposure to pine processionary caterpillar, one of severe orofacial edema and the other of periorbital cellulitis.
In conclusion:
- Contact with T.pityocampa may cause adverse reactions; kowing the possibility of this kind of reaction to the pine caterpillar can help medical staff in the differential diagnosis of such medical presentations.
- Pine processionary caterpillar exposure should be considered as a cause in the differential diagnosis of periorbital cellulitis as well as in the differential diagnosis of lips and tongue swelling.
