An unusual case of ingestion of a moth cocoon in a 14-month-old girl

Tripi, Paul A.; Lee, Richard; Keiper, Joe B.; Jones, Andrew W.; Arnold, James E.

doi:10.1016/j.amjoto.2008.09.015

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 31, Issue 2 , Pages 123-126, March 2010

An unusual case of ingestion of a moth cocoon in a 14-month-old girl

Paul A. Tripi, MD
- Department of Anesthesiology, University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Corresponding author. Department of Anesthesiology, University Hospitals Case Medical Center, 11100 Euclid Avenue, LKSD 5007, Cleveland, OH 44106-5007, USA. Tel.: +1 216 844 7340.
Richard Lee, MD
- Department of Otolaryngology—Head and Neck Surgery, University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
Joe B. Keiper, PhD
- Department of Invertebrate Zoology, The Cleveland Museum of Natural History, Cleveland, OH, USA
Andrew W. Jones, PhD
- Department of Ornithology, the Cleveland Museum of Natural History, Cleveland, OH, USA
James E. Arnold, MD
- Department of Otolaryngology—Head and Neck Surgery, University Hospitals Case Medical Center, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA

Received 9 September 2008 published online 27 March 2009.

Abstract

We present a case report of a 14-month-old girl who ingested a moth cocoon, which resulted in dramatic symptoms of irritability, drooling, and anorexia. Direct laryngoscopy, bronchoscopy, and esophagoscopy under general anesthesia revealed copious, tenaciously adherent, barbed hairs embedded in her tongue and buccal mucosa. Removal of the hairs with irrigation, suction, and brushing was unsuccessful and was eventually abandoned. In the following 48 hours, the girl recovered uneventfully with supportive care. The hairs were subsequently identified as coming from the hickory tussock moth (Lepidoptera: Arctiidae: Lophocampa caryae), which is ubiquitously distributed throughout much of North America. This is the first detailed case report of ingestion of an L caryae cocoon.