First case report of Ctenus medius envenomation: Clinical features of a patient bitten three times by the same spider.

ABSTRACT

A 22 years old undergraduate student was injured three times by a C. medius spider while wearing pants. Right foot and internal lower leg were bitten in three sites, leading to local pain and oedema, besides a total leg paresthesia as immediate symptoms. A series of photographs of the sites were taken since day 0 until resolution in day 10. Two hours after the accident, the victim received intravenous promethazine. Despite cessation of pain and paresthesia after 24 hours, an intense erythema and itching emerged reaching the maximum in day 4, when the victim returned to hospital and received topic dexamethasone and oral dexchlorpheniramine. The regression was complete in day 10. This accident opened room for discussion of empiric drug choice for immediate and subsequent symptoms of unknown envenomations, as good as a reference for further accidents with this common spider. Biological aspects such as venom composition and spider control of delivered venom amount are also discussed.