"Puss caterpillar" envenomation: a report from North Carolina.

A 41-year-old white man with no specific past medical history presented to the Emergency Department on October 13, 1997, following what he described as a "caterpillar bite." The insect was subsequently identified as a "puss caterpillar" (Megalopyge opercularis). The patient experienced immediate excruciating pain that radiated throughout his left arm and gradually spread to the left chest area. He presented to a nearby emergency department several hours later and received treatment. The patient was subsequently admitted for observation and released several days later. Viewed in the context of previous clinical reports, this case highlights the broad range of clinical symptoms that can result from the puss caterpillar sting.