Paederus Dermatitis among Monusco Peacekeepers about 52 Cases and Review of the Literature

Abstract

Background: High incidence of paederus insect dermatitis between peacekeepers. The aim: Of our work is to determine the epidemiological and clinical profile of this dermatitis with a review of the literature for the last 10 years, and shed light on this pathology to better prevent it, especially with peacekeepers and transients coming from non-endemic countries. Material and method: Retrospective epidemiological study of patient records from December 2020 to June 2021 concerning patients with paederus dermatitis at MONUSCO Level 2 Hospital in Bunia Democratic Republic of Congo and other level one hospitals of Ndoromo Camp, Kichanga and Butembo, with review of the literature for the last 10 years from the PubMed, Clinical Key and Cochrane databases. Results: 52 patients presented to MONUSCO Level 2 Hospital in Bunia and other level one hospital for skin and/or mucous membrane lesions following crushing on the paederus insect. In 13 cases (25%) the incident was unrecognized. The age was 24 to 42 years with an average of 34 and all male. Clinically burn pain in 94.2% cases with intense pruritus in 65% cases. Clinical examination found lesions such as macular and papillary erythema in all cases, bubbles 17.3%, vesicles 26.9%; mainly involving the neck (34 cases), the face (08 cases), the arm (5 cases) the eye (5 cases) the torso (4 cases) and other regions. Five patients had periorbital involvement mimicking orbital cellulitis in three cases (Figure 6) with periorbital edema and conjunctivitis. Some patients have one or more site of lesion, different functional signs and lesions on physical examination. All the patients were afebrile and did not present any symptoms favoring pathology. The interrogation revealed ignorance of this insect as well as the dermatitis it can cause in 73% of cases. The treatment was especially with local antibiotics and steroids. Three patients used honey as self-medication. The outcome under treatment was favorable in 67.3% of cases, with hyperpigmentation-type sequelae in 32.6% of cases. Conclusion: Paederus dermatitis is a little serious condition due to the possibility of orbital involvement and the cutaneous sequelae they can cause. It should be considered in the differential diagnosis of periocular infections and preseptal cellulitis. However, prevention remains the key to avoiding high incidence rates, especially among peacekeepers and transients coming from non-endemic countries.