ABSTRACT
The brown recluse spider (Loxosceles reclusa) is endemic to the southcentral Midwest and the Southern United States. A bite from a brown recluse spider may result in symptoms that range from local skin necrosis to systemic complications such as acute haemolytic anaemia, disseminated intravascular coagulopathy, rhabdomyolysis and death. Although rare, systemic loxoscelism is a clinical diagnosis of exclusion that should be considered in a patient with acute autoimmune haemolytic anaemia. We describe a case of a young man with autoimmune haemolytic anaemia secondary to systemic loxoscelism successfully treated with intravenous immunoglobulin and steroids.
Subject(s)
Anemia, Hemolytic, Autoimmune , Brown Recluse Spider , Spider Bites , Humans , Male , Anemia, Hemolytic, Autoimmune/diagnosis , Anemia, Hemolytic, Autoimmune/drug therapy , Anemia, Hemolytic, Autoimmune/complications , Anemia, Hemolytic, Autoimmune/etiology , Spider Bites/complications , Spider Bites/diagnosis , Animals , Immunoglobulins, Intravenous/therapeutic use , Adult , Young AdultSubject(s)
Erythema , Spider Bites , Humans , Erythema/etiology , Face , Spider Bites/complications , Spider Bites/diagnosisABSTRACT
Although there is an increased awareness of community-acquired methicillin-resistant Staphylococcus aureus (MRSA), there remains a bias of the public and health-care workers to blame spiders as a cause of skin and soft tissue infection when there is no valid incriminated evidence for this assumption. MRSA is a formidable infection and remains a threat to human health. Recognition and proper treatment by practitioners remain of utmost importance to improve patient outcomes.
Subject(s)
Methicillin-Resistant Staphylococcus aureus , Spider Bites , Humans , Spider Bites/diagnosis , Spider Bites/drug therapy , Health PersonnelABSTRACT
No disponible
Subject(s)
Humans , Female , Child , Brown Recluse Spider , Spider Bites/diagnosis , Spider Bites/drug therapy , Degloving InjuriesABSTRACT
Background: Loxoscelism is an important public health problem in Chile and South America, due to the higher rate of cutaneous-visceral involvement. The diagnosis of loxoscelism is mostly clinical without established diagnostic criteria. There is little evidence to support any treatment used in this condition. Aim: To characterize the clinical features and epidemiology of loxoscelism among patients consulting at the Emergency and Dermatology Services of a clinical hospital between 2013 and 2017. Material and Methods: Review of medical records of patients registered in the electronic clinical record system with a confirmed diagnosis of loxoscelism. Epidemiological, clinical, laboratory tests and treatment variables were analyzed. Results: We reviewed data from 200 patients. Ninety-four percent presented cutaneous loxoscelism and 5.5% cutaneous-visceral loxoscelism. Systemic symptoms were present in 73% of patients with cutaneous-visceral loxoscelism. Patients who developed systemic symptoms had an 18 times higher risk of developing cutaneous-visceral loxoscelism. Laboratory abnormalities were more common in patients with cutaneous-visceral loxoscelism. Not all patients with hematuria had cutaneous-visceral loxoscelism. Most patients required analgesia. Anti-loxosceles serum was not used in any patient. Conclusions: Many questions remain to be answered regarding the diagnosis and treatment of the disease. Studies are required to validate diagnostic criteria for loxoscelism, predictors for visceral involvement and response to treatment.
Subject(s)
Humans , Animals , Spider Bites/diagnosis , Spider Bites/therapy , Spider Bites/epidemiology , Spider Venoms , Spiders , Pain , Chile/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Spider Bites/surgery , Spider Bites/diagnosis , Erythema/surgery , Erythema/etiology , Debridement , Drainage , SpainABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Spider Bites/diagnosis , Spider Bites/etiology , Spider Bites/complications , Spider Bites/therapyABSTRACT
Se presentó un caso tratado en la Unidad Básica de Salud del poblado Pedras municipio Matoes Do Norte estado Maranhao Brasil, de una gestante de 32.4 semanas con lesión necrótica en la cara interna del muslo derecho provocado por la picadura de una araña marrón. Con el propósito de informar un caso de lesión producida por la picadura de este insecto y revisar la literatura médica se presentó este reporte sobre una gestante de 19 años donde el diagnóstico se estableció mediante estudio epidemiológico y características de la lesión siendo diagnosticada finalmente de loxoscelismo cutáneo, lesión producida por la picadura de araña marrón(AU)
It was presented a case in the Basic Health Unit of Pedras municipality Matoes Do Norte Maranhao Brazil, from a pregnant woman of 32.4 weeks with a necrotic lesion on the inner side of her right thigh caused by the bite of a brown spider. In order to report a case of injury caused by the brown spider bite and review the medical literature, this report is presented on a pregnant woman of 19 years where the diagnosis was established by epidemiological study and characteristics of the lesion being the final diagnosis of Loxoscelism cutaneous lesion produced by the brown spider bite(AU)
Subject(s)
Humans , Female , Pregnancy , Spider Bites/diagnosis , Spider Bites/epidemiology , Brown Recluse SpiderABSTRACT
Resumen Introducción: El loxoscelismo es una patología frecuente en nuestro medio con un amplio espectro de presentaciones y diagnósticos diferenciales, con complicaciones potencialmente graves, e incluso con riesgo de muerte. A la fecha no existe un tratamiento estándar para estos pacientes. Objetivo: Describir las manifestaciones clínicas, principales complicaciones, manejo terapéutico y evolución de pacientes internados por loxoscelismo en un hospital terciario en Chile. Pacientes y Método: Se analizaron todos los pacientes consultantes e internados por loxoscelismo en el Hospital Clínico de la Pontificia Universidad Católica de Chile entre los años 2014 y 2017, evaluados en interconsulta por Dermatología. Revisión de los registros clínicos incluyendo semiología, imágenes, informes de laboratorio y tratamientos efectuados. Resultados: Se registraron 17 casos de loxoscelismo de manejo hospitalario, cuya presentación responde al patrón epidemiológico nacional. La mayoría de los casos fue manejada con antimicrobianos, corticosteroides sistémicos, antihistamínicos y dapsona. De ellos, 11,8% correspondieron a loxoscelismo cutáneo visceral, manejados exitosamente con medidas de soporte, corticosteroides sistémicos y antihistamínicos. El 59% presentó resolución de las lesiones al mes de tratamiento, con cicatriz residual leve o hiperpigmentación postinflamatoria, sin mortalidad en nuestra serie. Discusión: La mayoría de los casos de loxoscelismo cutáneo presentó excelente respuesta y rápida resolución del cuadro tras el tratamiento asociado de corticosteroides sistémicos, antimicrobianos y dapsona, sugiriendo que el uso de estas terapias podría detener la progresión de la necrosis cutánea y prevenir las complicaciones asociadas al loxoscelismo.
Background: Loxoscelism is a common pathology in our environment with a broad spectrum of differential diagnoses and presentations, with potentially serious complications, even to the point of death. To date, there is no standard treatment for these patients. Aim: To describe the clinical manifestations, main complications, therapeutic management, and evolution of loxoscelism in an inpatient setting from a tertiary hospital in Chile. Methods: All patients consulting and hospitalized in the hospital of the Pontificia Universidad Católica de Chile with diagnosis of loxoscelism between 2014 to 2017 and evaluated by dermatologist were included. Review of clinical files, including symptoms, images, laboratory parameters and treatment. Results: We evaluated seventeen inpatient with loxoscelism, whose presentation responds to the national epidemiological pattern. Most cases were managed with antibiotics, systemic corticosteroids, antihistamines, and dapsone. From these, 11.8% corresponded to viscerocutaneous loxoscelism, successfully managed with supportive measures, systemic corticosteroids and antihistamines. Fifty-nine percent healed their cutaneous lesions after one month of treatment, with slight residual scarring or post inflammatory hyperpigmentation, without associated mortality in our series. Discussion: Most cases of cutaneous loxoscelism presented excellent response and rapid resolution of the disease after combined therapy with systemic corticosteroids, antibiotics and dapsone, suggesting that the use of these therapies could stop the progression of cutaneous necrosis and prevent complications associated with loxoscelism.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Spider Bites/complications , Skin Diseases/etiology , Spider Venoms/adverse effects , Spider Bites/diagnosis , Spider Bites/drug therapy , Seasons , Skin Diseases/diagnosis , Skin Diseases/drug therapy , Viscera/pathology , Retrospective StudiesABSTRACT
Se presentó un caso tratado en la Unidad Básica de Salud del poblado Pedras municipio Matoes Do Norte estado Maranhao Brasil, de una gestante de 32.4 semanas con lesión necrótica en la cara interna del muslo derecho provocado por la picadura de una araña marrón. Con el propósito de informar un caso de lesión producida por la picadura de este insecto y revisar la literatura médica se presentó este reporte sobre una gestante de 19 años donde el diagnóstico se estableció mediante estudio epidemiológico y características de la lesión siendo diagnosticada finalmente de loxoscelismo cutáneo, lesión producida por la picadura de araña marrón(AU)
It was presented a case in the Basic Health Unit of Pedras municipality Matoes Do Norte Maranhao Brazil, from a pregnant woman of 32.4 weeks with a necrotic lesion on the inner side of her right thigh caused by the bite of a brown spider. In order to report a case of injury caused by the brown spider bite and review the medical literature, this report is presented on a pregnant woman of 19 years where the diagnosis was established by epidemiological study and characteristics of the lesion being the final diagnosis of Loxoscelism cutaneous lesion produced by the brown spider bite(AU)
Subject(s)
Humans , Female , Spider Bites/diagnosis , Spider Bites/epidemiology , Female Urogenital Diseases and Pregnancy Complications , Brown Recluse SpiderABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Spider Bites/diagnosis , Spider Bites/drug therapy , Adrenal Cortex Hormones/therapeutic use , Analgesia , Diagnosis, Differential , Lip , Lip/injuriesABSTRACT
Abstract INTRODUCTION Infrared imaging (IR) is a noninvasive technique that quantifies body surface temperature, producing a digital color image. IR has been used to study diseases in which skin temperature can reflect the presence of inflammation. METHODS This was an observational pilot study of eight patients envenomed by snakes, spiders, and scorpions. All patients were examined using a thermal camera. RESULTS In all cases, we obtained infrared images that corroborated clinical findings indicating localized effects of venom, specifically inflammation. CONCLUSIONS IR has potential for use as a research, diagnostic, and monitoring tool for localized effects of animal venoms.
Subject(s)
Humans , Male , Female , Adult , Spider Bites/diagnosis , Snake Bites/diagnosis , Thermography/methods , Scorpion Stings/diagnosis , Spider Bites/complications , Snake Bites/complications , Pilot Projects , Scorpion Stings/complicationsABSTRACT
Introducción: El envenenamiento por mordedura de araña «viuda negra» (Latrodectus mactans) en niños se expresa clínicamente con neurotoxicidad. Objetivo: Identificar los signos y síntomas neurológicos característicos, en las diferentes edades pediátricas, la evolución y el tratamiento en pacientes atendidos por esta mordedura de en un hospital pediátrico de noroeste México. Material y métodos: Se revisaron 70 expedientes de niños hospitalizados entre 1978-2014; estableciéndose 2 grupos: grupo 1, de 33 lactantes y preescolares, y grupo 2, con 37 escolares y adolescentes. Las variables consideradas fueron: edad, género, lugar de procedencia, sitio del accidente, área corporal afectada, grado de envenenamiento, tratamiento, evolución clínica, diferencias estadísticas. Resultados: Predominó el género masculino, 61,4%; los lactantes menores de un año fueron un 14,2%. El 70% de los pacientes tuvieron el contacto con el arácnido dentro del domicilio; las áreas anatómicas más afectadas fueron miembros inferiores, cuello, tronco y abdomen; los signos y síntomas neurológicos más notables en el grupo 1 fueron: irritabilidad, llanto constante, naáseas, sialorrea, agitación, taquicardia, arritmias, incapacidad para caminar, espasmos musculares, parestesias, tetania, convulsiones, nistagmo. En el grupo 2 fueron: dolor local, cefalea, sialorrea, parestesias, sudoración profusa, ansiedad, debilidad muscular, espasmos musculares y temblor fino. La manifestación clínica autonómicas predominante en el grupo 1 fue sialorrea, p < 0,0001, y en el grupo 2, parestesias, p < 0,0001. El uso de faboterápicos en el tratamiento permitió mejor evolución, menor tiempo de hospitalización, no hubo mortalidad. Conclusiones: Los signos y los síntomas de la mordedura por araña «viuda negra» son predominantemente autonómicos; identificarlos permite el diagnóstico oportuno y tratamiento eficaz
Introduction: Envenomation by black widow spiders manifests clinically with signs of neurotoxicity in paediatric patients. Objective: Identify typical neurological signs and symptoms in paediatric patients of different ages, and describe treatment and outcomes in a paediatric hospital in northwest Mexico. Material and methods: We reviewed 70 clinical records of patients hospitalised due to black widow spider bite between 1978 and 2014. We divided the total into 2 groups: Group 1, infants and preschool children; and Group 2, school-age children and adolescents. The demographic variables were age, sex, birthplace, place where envenomation occurred, body part(s) affected, degree of envenomation according to signs and symptoms, treatment, clinical outcome, and statistical differences. Results: Boys accounted for 61.4% of all cases, and infants younger than one year old made up 14.2%. Most patients (70%) were bitten by the spider at home; the anatomical areas most frequently affected were the legs, neck, thorax, and abdomen. The neurological signs and symptoms displayed by Group 1 were irritability, constant crying, sialorrhoea, nausea, tachycardia, arrhythmias, fatigue when walking, agitation, muscle spasms paraesthesia, tetany, seizures, and nystagmus. Signs in Group 2 included localized pain, headache, sialorrhoea, paraesthesia, profuse sweating, anxiety, muscle weakness, muscle spasms, and fine tremor. The predominant autonomic sign in Group 1 was sialorrhoea (P<.0001) and in Group 2, paraesthesia (P<.0001). Patients who received Fab antivenom treatment displayed better outcomes and shorter hospital stays than those who did not. No deaths were reported. Conclusions: The neurological signs and symptoms caused by black widow spider bite are predominantly autonomic, and identifying them permits early diagnosis and more effective treatment
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Black Widow Spider/metabolism , Black Widow Spider/pathogenicity , Spider Bites/complications , Spider Bites/diagnosis , Spider Bites/therapy , Spider Venoms/poisoning , Spider Venoms/toxicity , Spider Venoms/therapeutic use , 26810/administration & dosage , 26810/pharmacology , 26810/therapeutic use , Retrospective Studies , Mexico/epidemiologyABSTRACT
Las picaduras de insecto constituyen un motivo habitual de consulta en Atención Primaria. Existen suficientes guías clínicas pediátricas y protocolos para atender de forma apropiada a los niños. Sin embargo, se trata de situaciones clínicas muy influenciadas por la tradición popular. Esto, en ocasiones, puede incluso alterar la actuación del pediatra, si se deja guiar por costumbres, prácticas y tratamientos basados en divulgación no científica. Se presenta una revisión sobre el tema con el objetivo principal de recomendar una actitud general para tratar las picaduras de insecto en niños. Se realizan además una serie de apreciaciones sobre algunos casos en particular, como por ejemplo arañas, escorpiones y garrapatas, siempre valorando las posibilidades reales en territorio español, sin considerar insectos tropicales o exóticos. También se abordan medidas preventivas frente a las picaduras y aspectos relativos a fenómenos alérgicos (AU)
Insect bites are a common reason for consultation in primary care. There are enough pediatric guidelines and protocols for treating children appropriately. However, stings are heavily influenced by lore. Because of this, pediatricians could change their performance sometimes, mainly if they are guided by customs and practices based on unscientific treatments. A review on the subject is presented with the aim of recommending a general attitude to treat insect bites in children. Several comments about some particular cases are also carried, such as spiders, scorpions and ticks, always taking into account the real possibilities in the Spanish territory, regardless of tropical or exotic insects. Preventive measures against stings and hypersensitivity phenomena are also covered in this document (AU)
Subject(s)
Child , Female , Humans , Male , Insect Bites and Stings/epidemiology , Insect Bites and Stings/prevention & control , Anaphylaxis/complications , Anaphylaxis/diagnosis , Anaphylaxis/therapy , Tick Bites/diagnosis , Tick Bites/therapy , Histamine Antagonists/therapeutic use , Analgesics/therapeutic use , Primary Health Care/methods , Primary Health Care/standards , Primary Health Care , Spider Bites/complications , Spider Bites/diagnosis , Spider Bites/therapy , Scorpion Stings/diagnosis , Scorpion Stings/therapyABSTRACT
Os acidentes com aranhas do gênero Loxosceles podem apresentar variadas evoluções clínicas, dificultando a realização do diagnóstico e a escolha correta de uma medida terapêutica. Este artigo de revisão tem como objetivo abordar os mais importantes mecanismos de evolução, principais desfechos e os tratamentos de escolha para o acidente loxoscélico (AU)
Accidents with Loxosceles genus spiders may have different clinical outcomes, hindering the diagnosis and the correct choice of a therapeutic measure. This review article aims to address the main mechanisms of evolution, main outcomes and treatments of choice for loxoscelic accident (AU)
Subject(s)
Humans , Animals , Spider Bites/diagnosis , Spider Bites/therapy , Brown Recluse Spider/pathogenicity , Spider Bites/complications , Spider Bites/physiopathology , Spider Bites/pathology , Spider Bites/prevention & control , Spider Bites/epidemiology , Brown Recluse Spider/enzymologySubject(s)
Adolescent , Child , Female , Humans , Male , Spider Bites/diagnosis , Enzyme-Linked Immunosorbent Assay , Sensitivity and SpecificityABSTRACT
Objetivo. Determinar las características clínicas y epidemiológicas del loxoscelismo en un hospital de primer nivel. Material y Métodos. En un estudio descriptivo y retrospectivo se evaluaron un total de 12 casos con diagnóstico de loxoscelismo en el Hospital I Edmundo Escomel, en el periodo comprendido entreenero de 2008 a abril de 2012. resultados. El 67% de los casos correspondió al sexo femenino, el grupo etario mas afectado fue el de 41-60 años (42%), y el lugar de procedencia fue de la zona urbana en el 58% de los casos. La forma clínica más común fue la cutánea (92%), la ubicación topográfica más común fue en las extremidades (inferiores 33% y superiores 25%), el tiempo transcurrido entre la mordedura y la ayuda médica fue en el 67% de los casos entre las 24 y 48 horas. Las manifestaciones locales más frecuentes fueron edema y eritema en el 100% de casos. El 92% de los pacientes estudiados presento hemoglobinuria. En el tratamiento se utilizó antibióticos (75%), esteroides (100%), bloqueadores H1 (75%) y bicarbonato (83%). Conclusión. El loxoscelismo produce una lesión altamente sugestiva y la suma de los hallazgos clínicos y epidemiológicos pueden establecer el diagnóstico, inclusive si la araña no es identificada o capturada.
Objective. To determine the clinical and epidemiological characteristics of loxoscelism in a first level hospital. Material and Methods. A retrospective and descriptive study was done on 12 cases of loxoscelism in the Hospital I EsSalud Edmundo Escomel, between January 2008 and April 2012. results. 67% of cases where female, the group age most affected was between 41 to 60 year-old (42%), the most frequent locations were areas around the city (58%). The most common lesion was cutaneous (92%). The majority of lesions were in extremities (lower 33% and upper 25%) The disease time until to arrive to the hospital was within the first 24 to 48 hours (67%), the most frequent local manifestations were erythema and edema (100%). Hemoglobinuria was found in 92%. As treatment, it was used antibiotics (75%), steroids (100%), H1 blockers (75%) and sodium bicarbonate (83%). Conclusion. Loxoscelism produce a highlysuggestive lesion and the sum of the epidemiologic and clinical features could establish the diagnosis, even the spider is not identified or captured.