A clinical and epidemiological study of Loxosceles spider envenoming in Santa Catarina, Brazil

Abstract

A clinical and epidemiological study of 267 cases of envenomation by Loxosceles spp. (loxoscelism), notified to Centro de Informações Toxicológicas de Florianópolis (Santa Catarina State, Brazil), was conducted between January 1985 and December 1995. Most of the incidents occurred along the coast of the mid-southern region of the state, during the warmest months. L. laeta and L. intermedia were identified as the causative agents. Cutaneous loxoscelism was clinically diagnosed in 232 (86.9%) patients with local pain (86.5%), oedema (80.5%), hyperaemia (79.8%) and necrosis (56.9%). Cutaneous-visceral loxoscelism was detected in 35 patients (13.1%) with intravascular haemolysis, manifested by jaundice (68.6%), oliguria (45.7%), dark urine (28.6%), haemorrhage (25.7%), anuria (8.6%) and shock (2.9%), besides the cutaneous effects. Specific antivenom was given to 125 patients (46.8%) and only 8 (6.5%) had mild reactions. Acute renal failure was observed in 17 cases (6.4%); 4 patients (1.5%) died, all of whom were children under 14 years old.

Clinical and epidemiological features of definitive and presumed loxoscelism in São Paulo, Brazil

“…Loxosceles spider bite (loxoscelism) has been reported in South America 6,18,26,27,28 , North America 2,11,15,24 , Southern Africa 19,20 and Israel…”

“…Systemic involvement (viscerocutaneous form) is much less common and is the cause of the rare deaths, usually associated with acute renal failure and disseminated intravascular coagulation due to intravascular hemolysis 27,28 . The mechanisms involved in the pathophysiology of Loxosceles envenoming are complex.…”

Acute Kidney Injury Induced by Snake and Arthropod Venoms

“…AKI occurred in 6.4 % of the patients, and most of them were diagnosed more than 24 hours after the bite. Four patients died (1.5 %), all of them were children under 14 years old (Sezerino et al, 1998). The main factors likely associated with AKI development are hemolysis, hypotension/shock, and direct venom nephrotoxicity (Table 2).…”

Necrotic skin lesion in a dog attributed to Loxosceles (brown spider) bite: a case report

“…In Brazil, seven species have been identified up to now, most of them in south and southeast regions whereas three of them are frequently associated to human envenomation cases (L. intermedia, L. gaucho and L. laeta) (4,5). Reports show that approximately 3,000 cases of human Loxosceles envenomations occur every year at the Brazilian state of Paraná (6).…”

“…Because of this, diagnosis is frequently based on epidemiology, history, clinical signs and on the exclusion of other causes instead of on the spider identification (4,5,(15)(16)(17) There is no specific treatment (Loxosceles antivenom) available for veterinary patients, thus complementary treatment with fluid therapy, osmotic diuresis with manitol, analgesia and broad spectrum antibiotic therapy may be necessary (10,18,19). In some cases, surgery may be necessary to repair skin lesions (11).…”