Sotelo-Cruz N, Hurtado-Valenzuela JG, Gómez-Rivera N

Language: Spanish
References: 24
Page: 103-108
PDF size: 444.25 Kb.

ABSTRACT

Introduction: Poisoning caused by “black widow” spider bite, is not commonly observed during childhood, it is not exempt from complications, and must be treated in time or the patient can die. In Mexico we do not have accurate data on the exact number of accidents due to this condition.
Objective: Identify the signs and characteristic symptoms of children treated at the Children’s Hospital from the state of Sonora with the aim of starting early treatment.
Material and Methods: We reviewed 43 clinical records of hospitalized patients admitted for “black widow” spider bite between 1978– 2004. Demographic variables were: age, gender, place of origin, place where accident took place, treatment given prior to hospital admittance, degree of envenomation measured by signs and symptoms, treatment and clinical evolution.
Results: 69.7% of cases were male, we did not find differences in the number of patients between infant, pre-school, elementary school children and teenagers. During summer and afternoon hours we registered 44% and 37% cases respectively; 74% patients were poisoned by the spider at home; the anatomical areas most affected were: arms, hands and thorax. Signs and symptoms in infants were: irritability, constanty cry, sialorrea, agitation erythema on wounded areas and seizures. Among elementary school children and teenagers signs included pain in wounded area, abdominal and thoracic, muscle spasms, fine tremor and residual signs. Patients who received fabotherapic treatment had better evolution and less time of hospitalization. No deaths were reported.
Conclusions: The different signs and symptoms between infants, pre-school, elementary school children and teenagers allowed us to clearly identify evenommation and differentiate it form confounding diseases. In our study, specific fabotherapy constituted the best treatment choice.

REFERENCES

1. Chávez-Haro L, Sánchez-Villegas MC, Osnaya-Romero N. Arácnidos de importancia clínica. En: Intoxicaciones. Asociación Mexicana de Pediatría. Martínez Pantaleón O. (Eds). McGraw-Hill, México, 2004. p. 367.

2. Masahisa ORI, Ikeda H. Spider venoms and spider toxins. J Toxicology Toxin Rev 1998;17;(3):405-426.

3. Cano AG. Animales y plantas venosas. Editores Universidad Kino, Instituto Sonorense de Cultura. Hermosillo, Sonora 1998. p. 7.

4. Hoffman A. El maravilloso mundo de los arácnidos. México Fondo de Cultura Económica. 1993. p. 74-84.

5. Better R. Bites and stings of medical important venenous arthopods. Int J Derm 1998;37:481-489.

6. Anuarios Estadísticos de la Secretaría de Salud y los Servicios de Salud de los Estados. Editorial Dirección General de Estadística e Informática, México, D. F. 1997, 1998, 1999.

7. Kemp ED. Bites and stings of the arthropod kind. Treating reactions that can range from annoying to menacing. Postgrad Med 1998;103;(6):88-90,93-96, 102 Review.

8. Magazanik LG, Fedrova IM, Kovalevskoya GJ, Pashkov VN, Bulgakov OV, Grishin EV. Selective presynaptic insectotoxin (latroinsectotoxin) isolated from black widow spider venom. Neuroscience 1992;46;(1):181-188.

9. Woestman R, Perkin R, Van Stralen D. The black widow: is she deadly? Pediatric Emerg Care 1996;12:360-368.

10. Bush SP, Norris MD, Van DeVoor TJT, Walker SJ, Roberge RJ. Spider envenomation widow . Medicine 2004. p. 1-2.

11. Brayan P. Black widow spider envenomation. Utox Update 2002;(4):1-5.

12. Allen C. Arachnid envenomations. Emerg Med Clinics North Am 1992;

13. 10;(2):269-298.

14. Stiles AD. Priapism following a black widow spider bite. Clin Pediatr (Phila) 1982;21:174-175.

15. Hoover NG, Fortenberry JD. Use of antivenin to treat priapism after widow black spider bite. Pediatrics 2004; e128 – e129 URL, http://www.pediatrics.org

16. Clark RF. The safety and efficacy of antivenin latrodectus mactans. Clin Toxicol 2001;39;(1):125-127.

17. Alagon-Cano A, González-Juárez C. De la seroterapia a la faboterapia. Envenenamiento por animales ponzoñosos un problema de salud en México. Instituto Bioclon 1998;2;(4):8-9

18. Moss HS, Binder LS. A retrospective review of black widow spider envenomation. Ann Emerg Med 1997;16;(2):188-192.

19. Norris RL. Delayed use of antivenin in black widow spider. J Wild Med 1991;2:187-192

20. Maretic Z. Latrodectism: Variations in clinical manifestations provoked by lactrodectus species of spider. Toxicon 1983;21:457-466.

21. Clark RF, Wethern-Kestner S, Vance MV, et al. clinical presentation and treatment of black widow spider envenomation: a Review of 163 cases. Ann Emerg Med 1992;21(7):782-787.

22. Tay-Zavala J, Díaz-Sánchez JG, Sánchez-Vega JT, Castillo-Alarcón L, Ruíz-Sánchez D, Calderón-Romero R. Picaduras por alacranes y arañas ponzoñosas de México. Rev Fac Med UNAM 2004;47;(1):6-12.

23. Calderon-Romero L, Tay-Zavala J, Sánchez-Vega JT, Ruíz-Sánchez D. Los artrópodos y su importancia en medicina humana. Rev Fac Med UNAM. 2004;47;(5):192-199.

24. Sotelo-C N, Hurtado-Valenzuela JG, Gómez-Rivera N. Envenenamiento en niños por mordedura de araña “latrodectus mactans” (viuda negra). Rev Mex Pediatr 2005;72;(1):31-35.