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AN UNWANTED KISS BY CHARLIE: AN UNUSUAL CASE REPORT
NMRR-20-37-52782

Ng KT, Tay HW, Singh N, Ferdinand JK

Introduction: Paederus fuscipes, commonly known as Charlie or rove beetle is a small red
and black striped winged beetle that produces a vesicant chemical paederin. Paederin is
15 times more potent than the venom of a cobra and is produced by an endosymbiont
bacterium within the beetle. Contact with skin causes presentation ranging from mild
dermatitis to more severe vesicles and bullae. Objective: To report a rare case of severe
lip destruction caused by Charlie. Case report: A 24-year-old male gave a history of
contact with Charlie on his lips. Clinically the lips were swollen, crusted and multiple
pustules were seen. Severe lip destruction was noted post wound debridement with loss
of normal anatomy of the lower lip. Treatment included daily wound debridement and
administration of intravenous antibiotics. A topical gel (NBF Gingival Gel) was applied
once daily onto the wound to aid in healing. Conclusion: The thinner stratum corneum on
the lips could have resulted in deeper penetration of the toxin paederin which accounts
for the severe presentation in this case. The application of NBF Gingival Gel can be used
to promote healing of wounds. Clinicians must be aware that contact with Charlie on the
lips can result in severe lip destruction.

Published in International Journal: Journal of Oral Maxillofac Surg 2020 Oct; 78(10): 1766 -1769
https://doi.org/10.1016/J.JOMS.2020.05.013

Dr Ng Kar Tsyeng
Dr Namkabir Singh
Dr Ferdinand Jesudian Kovilpillai
Department of Oral and Maxillofacial
Taiping Hospital

Dr Tay Hui Wen
Department of Oral and Maxillofacial Surgery
Kuala Lumpur Hospital

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