Cutaneous manifestations caused by Simulium erythrocephalum bites in humans: A case series

Introduction. In contact with insects, people present a wide range of reactions, local or systemic, whether caused by insect bites or a venom injections, sucking blood or exposure to insect's body and its secretions. Simulium erythrocephalum is an aggressive anthropophilic species, and following its bite humans may develop purpuric macules, edema and erythema surrounding the bite site. Our case series indicates frequent occurrence of Simulium erythrocephalum bites in Serbia. Case Series. We present a series of 30 cases reviewed between April and July 2006, who developed a local reaction at the site of this insect's bite. In all patients, the skin lesions were located on the extremities, mainly the lower legs. The number of bites varied from two to more than ten. In all patients the bites occurred either during outdoor activities on the riverside or their residence was near the Danube. The therapy with antihistamines, local and/or systemic corticosteroids, as well as symptomatic therapy, with compression and limb elevation was recommended. The skin lesions regressed in one week in most patients, but in few they lasted for several weeks. Conclusion. In addition to its impact on human health, Simulium erythrocephalum also has a role in veterinary medicine. Insect bites in animals can cause significant livestock losses, occasionally resulting in animal mortality. Apart from this, Simulium erythrocephalum may also be a vector in the transmission of the parasite from the genus of Leucocytozoon that infests birds.