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1.
Nat Commun ; 11(1): 2293, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32385249

RESUMO

The sodium channels Nav1.7, Nav1.8 and Nav1.9 are critical for pain perception in peripheral nociceptors. Loss of function of Nav1.7 leads to congenital insensitivity to pain in humans. Here we show that the spider peptide toxin called HpTx1, first identified as an inhibitor of Kv4.2, restores nociception in Nav1.7 knockout (Nav1.7-KO) mice by enhancing the excitability of dorsal root ganglion neurons. HpTx1 inhibits Nav1.7 and activates Nav1.9 but does not affect Nav1.8. This toxin produces pain in wild-type (WT) and Nav1.7-KO mice, and attenuates nociception in Nav1.9-KO mice, but has no effect in Nav1.8-KO mice. These data indicate that HpTx1-induced hypersensitivity is mediated by Nav1.9 activation and offers pharmacological insight into the relationship of the three Nav channels in pain signalling.


Assuntos
Hiperalgesia/induzido quimicamente , Hiperalgesia/metabolismo , Ativação do Canal Iônico , Canal de Sódio Disparado por Voltagem NAV1.7/metabolismo , Canal de Sódio Disparado por Voltagem NAV1.9/metabolismo , Peptídeos/efeitos adversos , Venenos de Aranha/efeitos adversos , Sequência de Aminoácidos , Animais , Feminino , Gânglios Espinais/patologia , Humanos , Hiperalgesia/complicações , Masculino , Camundongos Knockout , Canal de Sódio Disparado por Voltagem NAV1.7/química , Canal de Sódio Disparado por Voltagem NAV1.8/metabolismo , Canal de Sódio Disparado por Voltagem NAV1.9/química , Neurônios/efeitos dos fármacos , Neurônios/patologia , Dor/complicações , Dor/fisiopatologia , Ratos
3.
J Emerg Med ; 57(4): 523-526, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31492593

RESUMO

BACKGROUND: Black widow spider (Latrodectus spp) envenomation represents the most medically significant spider envenomation in the United States, prompting more than 2500 calls to poison centers annually. The female spider, which is responsible for symptomatic envenomations, is classically described as a shiny black spider with a red hourglass-shaped marking on the ventral abdomen. Clinical features of envenomation include painful muscle cramping, abdominal pain, and autonomic disturbances, such as tachycardia, hypertension, and diaphoresis. "Latrodectus facies" or "facies latrodectismica" is an additional distinctive but rarely described clinical finding characterized by periorbital edema, lacrimation, and blepharospasm. CASE REPORT: A 6-year-old female developed the typical clinical features of Latrodectus envenomation after being found in bed with a Western black widow spider (Latrodectus hesperus) with no ventral marking. She initially improved with opioid analgesia, but 6 h later her symptoms worsened again, and concurrent with this worsening she developed Latrodectus facies. She received additional opioid analgesia and all her symptoms resolved within 24 h. Her mother provided informed and written consent for the acquisition and publication of the facial photographs presented. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: A high degree of clinical suspicion is necessary to correctly diagnose Latrodectus envenomation, especially when the spider escapes unnoticed or in young children in whom the bite is not witnessed. To our knowledge, Latrodectus facies has not been reported previously in a young child, and recognition of this finding will aid clinicians in limiting unnecessary interventions and administering appropriate therapy.


Assuntos
Viúva Negra/patogenicidade , Face/anormalidades , Venenos de Aranha/efeitos adversos , Animais , Antivenenos/uso terapêutico , Criança , Serviço Hospitalar de Emergência/organização & administração , Face/fisiopatologia , Feminino , Dor no Flanco/etiologia , Humanos , Manejo da Dor/métodos , Manejo da Dor/normas , Venenos de Aranha/metabolismo
4.
Rev Chilena Infectol ; 35(3): 266-275, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30534906

RESUMO

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.


Assuntos
Dermatopatias/etiologia , Picaduras de Aranhas/complicações , Venenos de Aranha/efeitos adversos , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estações do Ano , Dermatopatias/diagnóstico , Dermatopatias/tratamento farmacológico , Picaduras de Aranhas/diagnóstico , Picaduras de Aranhas/tratamento farmacológico , Vísceras/patologia , Adulto Jovem
6.
Rev. Col. Méd. Cir. Guatem ; 156(1): 47-50, 2017 jul. ilus
Artigo em Espanhol | LILACS | ID: biblio-982135

RESUMO

La mordedura por araña del género Loxosceles produce dermonecrosis en el sitio de la lesión y complicaciones sistémicas secundarias a reacciones enzimáticas de su veneno, lo que aumenta la tasa de mortalidad. El objetivo es reportar cuatro casos de loxoscelismo atendidos en el hospital General San Juan de Dios, donde los pacientes tuvieron una evolución satisfactoria a pesar de la inexistencia del antiveneno como manejo ideal de la toxicidad (AU)


Assuntos
Humanos , Feminino , Picaduras de Aranhas/tratamento farmacológico , Venenos de Aranha/efeitos adversos , Aranha Marrom Reclusa/patogenicidade , Hemólise , Guatemala
7.
Wien Klin Wochenschr ; 129(17-18): 630-633, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28540455

RESUMO

In Central Europe, reports of human envenomation by Cheiracanthium punctorium, commonly known as the yellow sac spider, are sporadic, despite the fact that this species is widespread in Europe. However, in recent years, C. punctorium has been repeatedly described globally in medical and toxicological literature. Its venom was found to possess insecticidal, haemolytic, cytotoxic, and membrane-damaging activities. Its bite is often very painful, frequently associated with local and transient cutaneous and neurotoxic effects, but sometimes also with systemic symptoms which require medical help. The main objective of this article is to introduce more details about C. punctorium, the clinical manifestations and circumstances of its bite, the characteristics of its venom and proposed clinical management. The authors provide case reports of patients bitten by C. punctorium during the 10-year observational period. All patients presented in this article showed generally mild clinical manifestations and recovered completely without sequelae. No further treatment in terms of hospital surveillance or specific clinical measures was necessary in any of the reported cases.


Assuntos
Traumatismos da Mão/epidemiologia , Picaduras de Aranhas/epidemiologia , Venenos de Aranha/efeitos adversos , Animais , Estudos Transversais , Edema/etiologia , Eritema/etiologia , Primeiros Socorros , Seguimentos , Traumatismos da Mão/diagnóstico , Traumatismos da Mão/terapia , Humanos , Eslovênia , Picaduras de Aranhas/diagnóstico , Picaduras de Aranhas/terapia
8.
Pflugers Arch ; 468(5): 881-94, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26898377

RESUMO

The venom of the Brazilian armed spider Phoneutria nigriventer is a rich source of biologically active peptides that have potential as analgesic drugs. In this study, we investigated the analgesic and adverse effects of peptide 3-5 (Tx3-5), purified from P. nigriventer venom, in several mouse models of pain. Tx3-5 was administered by intrathecal injection to mice selected as models of postoperative (plantar incision), neuropathic (partial sciatic nerve ligation) and cancer-related pain (inoculation with melanoma cells) in animals that were either sensitive or tolerant to morphine. Intrathecal administration of Tx3-5 (3-300 fmol/site) in mice could either prevent or reverse postoperative nociception, with a 50 % inhibitory dose (ID50) of 16.6 (3.2-87.2) fmol/site and a maximum inhibition of 87 ± 10 % at a dose of 30 fmol/site. Its effect was prevented by the selective activator of L-type calcium channel Bay-K8644 (10 µg/site). Tx3-5 (30 fmol/site) also produced a partial antinociceptive effect in a neuropathic pain model (inhibition of 67 ± 10 %). Additionally, treatment with Tx3-5 (30 fmol/site) nearly abolished cancer-related nociception with similar efficacy in both morphine-sensitive and morphine-tolerant mice (96 ± 7 and 100 % inhibition, respectively). Notably, Tx3-5 did not produce visible adverse effects at doses that produced antinociception and presented a TD50 of 1125 (893-1418) fmol/site. Finally, Tx3-5 did not alter the normal mechanical or thermal sensitivity of the animals or cause immunogenicity. Our results suggest that Tx3-5 is a strong drug candidate for the treatment of painful conditions.


Assuntos
Analgésicos/uso terapêutico , Dor do Câncer/tratamento farmacológico , Neuralgia/tratamento farmacológico , Neuropeptídeos/uso terapêutico , Neurotoxinas/uso terapêutico , Venenos de Aranha/uso terapêutico , Analgésicos/efeitos adversos , Analgésicos/farmacologia , Animais , Agonistas dos Canais de Cálcio/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neuropeptídeos/efeitos adversos , Neuropeptídeos/farmacologia , Neurotoxinas/efeitos adversos , Neurotoxinas/farmacologia , Nociceptividade/efeitos dos fármacos , Venenos de Aranha/efeitos adversos , Venenos de Aranha/farmacologia
9.
Joint Bone Spine ; 83(1): 85-7, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26494589

RESUMO

Systemic lupus erythematosus is a chronic autoimmune disease with a relapsing and remitting course characterized by disease flares. Flares are a major cause of hospitalization, morbidity and mortality in patients with systemic lupus erythematosus. Some triggers for these exacerbations have been identified, including infections, vaccines, pregnancy, environmental factors such as weather, stress and drugs. We report a patient who presented with a lupus flare with predominantly mucocutaneous, serosal and cardiac involvement after being bitten by a spider and we present the possible mechanisms by which the venom elicited such a reaction. To the best of our knowledge, this is the first such case reported in the literature.


Assuntos
Lúpus Eritematoso Sistêmico/etiologia , Picaduras de Aranhas/complicações , Adulto , Feminino , Humanos , Venenos de Aranha/efeitos adversos , Exacerbação dos Sintomas
10.
Toxicon ; 108: 53-61, 2015 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-26435340

RESUMO

Venom-derived peptides constitute a unique source of drug prototypes for the pain management. Many of them can modulate voltage-gated calcium channels that are central in the processing of pain sensation. PhTx3-4 is a peptide isolated from Phoneutria nigriventer venom, which blocks high voltage-activated calcium channels with low specificity, thereby leading to neuroprotection in models of ischemia in vitro. The aim of the present work was evaluating the potential of intrathecal PhTx3-4 in the reversal of different nociceptive states in mice, furthermore assessing the potential of PhTx3-4 in triggering motor side effects. We found that bellow 100 pmol/site, PhTx3-4 did not cause major motor side effects. By comparison, ω-conotoxin MVIIA and ω-conotoxin MVIIC triggered motor side effects at the doses of 10 and 100 pmol/site, respectively. Also, PhTx3-4 (30 pmol/site) caused no significant alterations in the forced locomotor activity test (rotarod) and in the exploratory activity test (versamax). In a model of inflammatory persistent pain (formalin test), PhTx3-4 reversed nociceptive behavior both pre or post-administered, although this effect was observed only at the inflammatory phase of the test and not at the neurogenic phase. Comparatively, ω-conotoxin MVIIC was effective only when post-administered in the formalin test. Nonetheless, PhTx3-4 treatment was devoid of action in acute nociceptive thermal model (hotplate test), whereas morphine showed efficacy in this test. Efficacy of PhTx3-4 in the formalin test was associated with inhibition of formalin-induced glutamate release in the cerebrospinal fluid. PhTx3-4, but not ω-conotoxin MVIIC, reversed NMDA-induced nociceptive behavior indicating a putative role of PhTx3-4 at ionotropic glutamate receptors. Finally, we observed efficacy of PhTx3-4 in ameliorating mechanical hypersensitivity induced by paw incision, a post-operative and more clinically relevant pain model. Taken together, our data show that PhTx3-4 possesses antinociceptive effect in different models of pain in mice, suggesting that this toxin may serve as drug prototype for pain control.


Assuntos
Analgésicos/farmacologia , Neuropeptídeos/farmacologia , Neurotoxinas/farmacologia , Dor/tratamento farmacológico , Venenos de Aranha/farmacologia , Analgésicos/efeitos adversos , Analgésicos/uso terapêutico , Animais , Masculino , Camundongos , Neuropeptídeos/efeitos adversos , Neuropeptídeos/uso terapêutico , Neurotoxinas/efeitos adversos , Neurotoxinas/uso terapêutico , Dor/prevenção & controle , Venenos de Aranha/efeitos adversos , Venenos de Aranha/uso terapêutico , Aranhas/química
11.
Rev. Rol enferm ; 38(5): 374-381, mayo 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-139938

RESUMO

El loxoscelismo es un cuadro tóxico producido por el veneno que inoculan con su mordedura las arañas del género Loxosceles («arañas de rincón»). Puede presentarse bajo dos formas clínicas: loxoscelismo cutáneo y loxoscelismo cutáneo-visceral. En España se encuentra la especie Loxosceles rufescens, a la que se le han atribuido casos de loxoscelismo cutáneo. El loxoscelismo cutáneo se inicia con prurito, posteriormente dolor intenso y evoluciona hacia una forma necrosante más grave o bien a una forma edematosa, de mejor pronóstico, como el caso que exponemos a continuación. El diagnóstico es clínico. El tratamiento sistémico consiste en analgésicos, antihistamínicos, corticoides, antibióticos de amplio espectro y dapsona en casos graves. El tratamiento local se basa en la limpieza y el desbridamiento de la lesión y curas avanzadas para heridas complejas. No es infrecuente que requieran injerto cutáneo. El caso que exponemos es el de una joven de 18 años que sufrió la picadura o mordedura de una loxosceles en el dorso del pie y que desarrolló una necrosis de tejidos profundos en la zona. Presentó complicaciones sistémicas como leucocitosis y fiebre y también infección local y celulitis, por lo que requirió tratamiento sistémico e ingreso hospitalario y curas de terapéutica avanzada. Finalmente se ha conseguido la recuperación de la integridad cutánea en 84 días (AU)


Loxocelism is a toxic condition produces by the venom inoculated by the bit of the recluse spider (genus Loxosceles). In can appear in two clinical forms: cutaneous loxocelism and viscerocutaneous loxocelim. The species Loxoceles rufescens, found in Spain, is responsible of cases of cutaneous loxocelism. Cutaneous loxocelism starts with an itch, later giving rise to intense pain, and it later takes either a more or less severe necrotic form or an edematous form. The latter, with a better prognosis, is the one we focus on here. The diagnosis is clinical. The systemic treatment consists in analgesics, antihistamines, corticosteroids, broad-spectrum antibiotics, and dapsone in severe cases. The local treatment is based on the cleaning and debridement of the wound, and in advanced treatments for complex wounds. It is not uncommon that such wounds require skin grafting. We present the case of an 18-year female bitten by a loxosceles on the dorsal area of the foot. She developed a deep tissue necrosis in the area. She presented systemic complications such as leucocitosis, fever, local infection and cellulitis. Systemic treatment and hospitalization were required, as well as advanced therapeutic care. Finally, cutaneous integrity was restored after 84 days (AU)


Assuntos
Humanos , Picaduras de Aranhas/epidemiologia , Venenos de Aranha/efeitos adversos , Picaduras de Aranhas/enfermagem , Polímeros/uso terapêutico , Analgésicos/uso terapêutico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Corticosteroides/uso terapêutico , Úlcera Cutânea/etiologia
13.
Neuropharmacology ; 79: 657-67, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24467846

RESUMO

N-type calcium channels play important roles in the control of neurotransmission release and transmission of pain signals to the central nervous system. Their selective inhibitors are believed to be potential drugs for treating chronic pain. In this study, a novel neurotoxin named Huwentoxin-XVI (HWTX-XVI) specific for N-type calcium channels was purified and characterized from the venom of Chinese tarantula Ornithoctonus huwena. HWTX-XVI is composed of 39 amino acid residues including six cysteines that constitute three disulfide bridges. HWTX-XVI could almost completely block the twitch response of rat vas deferens to low-frequency electrical stimulation. Electrophysiological assay indicated that HWTX-XVI specifically inhibited N-type calcium channels in rat dorsal root ganglion cells (IC50 ∼60 nM). The inhibitory effect of HWTX-XVI on N-type calcium channel currents was dose-dependent and similar to that of CTx-GVIA and CTx-MVIIA. However, the three peptides exhibited markedly different degrees of reversibility after block. The toxin had no effect on voltage-gated T-type calcium channels, potassium channels or sodium channels. Intraperitoneal injection of the toxin HWTX-XVI to rats elicited significant analgesic responses to formalin-induced inflammation pain. Toxin treatment also changed withdrawal latency in hot plate tests. Intriguingly, we found that intramuscular injection of the toxin reduced mechanical allodynia induced by incisional injury in Von Frey test. Thus, our findings suggest that the analgesic potency of HWTX-XVI and its greater reversibility could contribute to the design of a novel potential analgesic agent with high potency and low side effects.


Assuntos
Analgésicos/farmacologia , Bloqueadores dos Canais de Cálcio/farmacologia , Canais de Cálcio Tipo N/metabolismo , Hiperalgesia/tratamento farmacológico , Dor/tratamento farmacológico , Venenos de Aranha/farmacologia , Sequência de Aminoácidos , Analgésicos/efeitos adversos , Analgésicos/química , Animais , Sequência de Bases , Bloqueadores dos Canais de Cálcio/efeitos adversos , Bloqueadores dos Canais de Cálcio/química , Canais de Cálcio Tipo T/metabolismo , Relação Dose-Resposta a Droga , Feminino , Gânglios Espinais/efeitos dos fármacos , Gânglios Espinais/fisiologia , Masculino , Dados de Sequência Molecular , Canais de Potássio/metabolismo , Ratos , Ratos Sprague-Dawley , Canais de Sódio/metabolismo , Venenos de Aranha/efeitos adversos , Venenos de Aranha/química , Aranhas , Ducto Deferente/efeitos dos fármacos , Ducto Deferente/fisiologia , Xenopus laevis
14.
Cutan Ocul Toxicol ; 32(1): 83-5, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22320167

RESUMO

Loxosceles Spiders have a worldwide distribution and are considered one of the most medically important groups of Spiders. The venom from Spiders of the genus Loxosceles, the most famous being Loxosceles reclusa (brown recluse Spider), can promote severe local and systemic damages. This report describes a girl presenting with a Spider bite over her right upper eyelid.


Assuntos
Diester Fosfórico Hidrolases/efeitos adversos , Picaduras de Aranhas/diagnóstico , Venenos de Aranha/efeitos adversos , Adolescente , Antibacterianos/uso terapêutico , Infecções Bacterianas/prevenção & controle , Pálpebras , Feminino , Humanos , Picaduras de Aranhas/terapia
15.
Wilderness Environ Med ; 23(2): 158-60, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22495094

RESUMO

Horner's syndrome involves a triad of eyelid ptosis, miosis, and facial anhidrosis that results from disruption of the oculosympathetic pathway. Acquired Horner's syndrome is associated with a variety of medical conditions including Pancoast tumor and carotid dissection. We report the unique case of a 47-year-old man presenting with Horner's syndrome 4 weeks after black widow spider envenomation. Workup did not reveal any alternative explanatory etiology. We hypothesize that late sequelae of black widow spider envenomation secondary to autonomic nerve injury or retrograde axonal transport after mechanical inoculation may have led to an acquired defect in the oculosympathetic pathway resulting in a Horner's syndrome. This case introduces a rare cause of Horner's syndrome and highlights the importance of environmental exposures in the evaluation of these patients.


Assuntos
Síndrome de Horner/diagnóstico , Síndrome de Horner/etiologia , Picaduras de Aranhas/complicações , Venenos de Aranha/efeitos adversos , Animais , Viúva Negra , Humanos , Masculino , Pessoa de Meia-Idade , Picaduras de Aranhas/diagnóstico
16.
J Ark Med Soc ; 108(10): 208-10, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22479977

RESUMO

Brown recluse spiders are predominantly found in south central United States. Their bites usually cause mild self-limiting reactions, although localized tissue necrosis and rare systemic, potentially fatal, envenomations are known to occur. Herein, we report an atypical presentation of a brown recluse bite in a 20 year old female who was admitted to the intensive care unit due to angioedema and cellulitis. We photographically document the bite site for twenty-four hours following envenomation. She received glucocorticoids, antihistamines, antibiotics and dapsone while hospitalized and was subsequently discharged with complete resolution of symptoms without the development of tissue necrosis or scarring.


Assuntos
Anafilaxia/etiologia , Mordeduras e Picadas/complicações , Lábio/lesões , Diester Fosfórico Hidrolases/efeitos adversos , Venenos de Aranha/efeitos adversos , Aranhas , Anafilaxia/patologia , Animais , Arkansas , Mordeduras e Picadas/patologia , Feminino , Humanos , Lábio/patologia , Adulto Jovem
17.
Wilderness Environ Med ; 23(1): 49-50, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22441089

RESUMO

Although wolf spider venom has been implicated in necrotic arachnidism without acceptably documented verification, limited, prospectively collected data demonstrate a lack of cutaneous necrosis. The infrequent nature of exposure and inherent difficulty in confirming wolf spider bites in humans makes it challenging to study such envenomations. We present the case of a 20 year-old man with confirmed exposure to the wolf spider who developed cutaneous erythema with ulceration following the bite. There was no evidence of skin necrosis. He was treated with aggressive wound care and systemic antibiotics for wound infection, with subsequent resolution of symptoms. This case adds to the limited knowledge regarding wolf spider envenomations and describes the clinical effects and management of wolf spider envenomation.


Assuntos
Eritema/etiologia , Úlcera Cutânea/etiologia , Picaduras de Aranhas/complicações , Picaduras de Aranhas/terapia , Venenos de Aranha/efeitos adversos , Animais , Antibacterianos/uso terapêutico , Eritema/terapia , Humanos , Masculino , Necrose/etiologia , Necrose/patologia , Pele/patologia , Úlcera Cutânea/terapia , Adulto Jovem
18.
Pediatr Dermatol ; 28(6): 685-8, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22082464

RESUMO

Previously reported cases of acute generalized exanthematous pustulosis secondary to brown recluse spider bite have been questioned due to lack of identification of the spider or because of the concomitant administration of antibiotics. We report a 9-year-old boy who arrived at the emergency department with a confirmed Loxosceles reclusa bite to the neck. On the third day of hospitalization, he developed hundreds of monomorphous, sterile pustules, initially in intertriginous areas. The eruption disseminated and was followed by pinpoint desquamation typical for acute generalized exanthematous pustulosis. During this he also developed late onset Coombs-positive hemolytic anemia and systemic loxoscelism. Sphingomyelinase in Loxosceles venom induces the production of interleukin-8 and granulocyte-macrophage colony-stimulating factor, cytokines involved in the pathogenesis of acute generalized exanthematous pustulosis, providing a mechanism by which Loxosceles reclusa bite may trigger acute generalized exanthematous pustulosis. We suggest that this case adds Loxosceles envenomation to the spectrum of agents that can trigger acute generalized exanthematous pustulosis.


Assuntos
Pustulose Exantematosa Aguda Generalizada/etiologia , Anemia Hemolítica/etiologia , Diester Fosfórico Hidrolases/efeitos adversos , Venenos de Aranha/efeitos adversos , Pustulose Exantematosa Aguda Generalizada/diagnóstico , Anemia Hemolítica/diagnóstico , Transfusão de Sangue , Criança , Teste de Coombs , Dopamina/uso terapêutico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/biossíntese , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/terapia , Humanos , Interleucina-8/biossíntese , Masculino , /terapia , Esfingomielina Fosfodiesterase/efeitos adversos , Resultado do Tratamento , Urobilinogênio/urina
19.
Lancet ; 378(9808): 2039-2047, 2011 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-21762981

RESUMO

Spiders are a source of intrigue and fear, and several myths exist about their medical effects. Many people believe that bites from various spider species cause necrotic ulceration, despite evidence that most suspected cases of necrotic arachnidism are caused by something other than a spider bite. Latrodectism and loxoscelism are the most important clinical syndromes resulting from spider bite. Latrodectism results from bites by widow spiders (Latrodectus spp) and causes local, regional, or generalised pain associated with non-specific symptoms and autonomic effects. Loxoscelism is caused by Loxosceles spp, and the cutaneous form manifests as pain and erythema that can develop into a necrotic ulcer. Systemic loxoscelism is characterised by intravascular haemolysis and renal failure on occasion. Other important spiders include the Australian funnel-web spider (Atrax spp and Hadronyche spp) and the armed spider (Phoneutria spp) from Brazil. Antivenoms are an important treatment for spider envenomation but have been less successful than have those for snake envenomation, with concerns about their effectiveness for both latrodectism and loxoscelism.


Assuntos
Picaduras de Aranhas/diagnóstico , Picaduras de Aranhas/terapia , Analgésicos/uso terapêutico , Animais , Antivenenos/uso terapêutico , Viúva Negra , Equimose/etiologia , Eritema/etiologia , Fadiga/etiologia , Cefaleia/etiologia , Humanos , Hiperidrose/etiologia , Masculino , Náusea/etiologia , Necrose , Dor/etiologia , Paralisia/etiologia , Priapismo/etiologia , Pele/patologia , Úlcera Cutânea/etiologia , Úlcera Cutânea/patologia , Picaduras de Aranhas/epidemiologia , Venenos de Aranha/efeitos adversos , Vômito/etiologia
20.
Turk J Pediatr ; 53(1): 87-90, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21534346

RESUMO

Spider bites are a worldwide problem. Brown recluse spider bites can lead to severe local or systemic clinical effects, such as edema, necrotic ulcer, rashes, fever, chills, nausea, vomiting, malaise, arthralgia, myalgia, hemolysis, leukocytosis, disseminated intravascular coagulation, renal failure, and death. Eyelid bites from brown recluse spiders are rare. We report a child with severe facial edema and a dermonecrotic ulcer on the eyelid. Upon laboratory examination, leukocytosis with a significant left shift was detected. The patient was treated with antibiotics, systemic corticosteroid and conservative therapy that included saline compresses and ocular lubrication. No surgical excision was required. Vision was not impaired. A dermonecrotic ulcer is a severe complication of brown recluse spider bites. Since the diagnosis is difficult, clinical and epidemiological findings and a detailed history are important for an accurate diagnosis.


Assuntos
Edema/etiologia , Doenças Palpebrais/etiologia , Diester Fosfórico Hidrolases/efeitos adversos , Picaduras de Aranhas/complicações , Venenos de Aranha/efeitos adversos , Úlcera/etiologia , Criança , Doenças Palpebrais/patologia , Humanos , Masculino , Necrose , Úlcera/patologia
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