Poisoning in Chile: A 10-year report from the Catholic University Poison Center

Ríos, Juan Carlos; Mieres, Juan José; Cerda, Patricia; Silva, L.; Olivares, Patrícia; Medel, P.; Solari, Sandra; Paris, Enrique

doi:10.1016/j.toxlet.2016.06.1430

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“…The toxic and dermonecrotic visceral damage are produced by the coagulant, hemolytic and vasculitic necrotizing properties of the spider venom, with sphingomyelinase being its most toxic component, responsible for neutrophil activation and alteration of the complement system, causing the various presentations of loxoscelism. The most common form is the cutaneous loxoscelism (83% of cases), followed by the cutaneous-visceral form (16% of cases), with a mortality rate of 1-3%, in which the venom enters the bloodstream, causing hemolytic alterations, with consequent involvement of several organs [11,15,16]. Several studies have correlated the presence and severity of loxoscelism with patient characteristics such as age, sex, bite site, comorbidities, immune system, and others [1,7,11,12,[16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Clinical Evolution After Administering Antivenom in Patients With Loxoscelism

Azuara-Antonio,

Ortiz,

Jimenez-Oliver

et al. 2023

J Med Cases

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Spiders are the most numerous arthropods of the arachnid class. More than 45 thousand species of spiders have been identified, and only a few are dangerous to humans. Among them, the "violin spider" or "brown spider" of the genus Loxosceles (family Sicariidae) has a worldwide distribution, and its bite can cause loxoscelism. Initial treatment of a Loxosceles spider bite includes application of local cold, rest, elevation of the extremity if possible, and systemic pharmacotherapy with antihistamines, corticosteroids, antibiotics, polymorphonuclear inhibitors, and analgesics or nonsteroidal anti-inflammatory drugs. During cutaneous or systemic loxoscelism, administration of Loxosceles antivenom (immunoglobulin (Ig)G F(ab')2 fragments) may be indicated to prevent progression to severe systemic phases. In this manuscript, we present three cases of patients with loxoscelism treated with the fabotherapeutic Reclusmyn ® , developed and manufactured in Mexico. Two patients had a satisfactory outcome without severe skin or systemic damage. Only one patient with loxoscelism, despite early initiation of antivenom, had extensive skin lesions that healed satisfactorily, leaving only a non-disabling scar. Due to the global presence of this clinical problem, further studies are needed to establish local and general guidelines for the treatment and prevention of loxoscelism. This will allow health professionals to provide more efficient and higher quality medical care and feel supported in their decisions.

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