Acute Myocarditis After Black Widow Spider Bite: A Case Report

Abstract

The black widow spider (BWS) is a venomous spider whose bite can cause various clinical conditions that range from local damage to serious systemic complications, including death. Cases of myocarditis following a BWS bite are rare but they can be fatal on occasion. However, the prognostic significance of the bite and presentation of myocarditis is unknown. Our case involved a 50-year-old man who presented with myocarditis after being bitten by a BWS and subsequently admitted to the intensive care unit for cardiac monitoring. During the hospital stay, he showed worsening signs on both the electrocardiographic and echocardiographic evaluations despite therapeutic success. Subsequent cardiac magnetic resonance and coronary angiography investigations showed no significant alterations; blood and instrumental test results slowly improved, and the patient was discharged home after 12 days of hospitalization without complications. This case illustrates that acute myocarditis, although an infrequent complication of BWS bite, has the potential to be lethal. The correct diagnosis, which is not always easy to formulate, is important to identify those patients who can benefit from careful monitoring and specific therapies aimed at reducing the risk of life.

Reversible myocarditis following Black widow spider (Latrodectus spp.) bite in Egypt

“…Our patient had developed the commonly reported symptoms of latrodectism, such as nausea, pain, muscle rigidity, headache, tremors, and muscle cramping. 3,[5][6][7][8]15,16 In addition, a moderate degree of priapism was reported, which is also recorded in the literature. 3 The hypertension and tachypnea that our patient developed were similar to previous studies.…”

“…Most cases have been reported in males, and most of them had myocarditis after BWS bite. [3][4][5][7][8][9][10]15,16 The majority of cases presented with chest pain or other manifestations suggesting pulmonary edema or heart failure. [3][4][5][7][8][9][10]15,16 Eight cases showed elevated levels of cardiac biomarkers.…”

“…2 Patients who have been bitten by a BWS typically complain of various clinical symptoms that range from local to systemic manifestations; a BWS bite can cause soft tissue damage at the site of the bite, with local to generalized pain and/or paresthesia. 3,6,7,15,16 In addition, priapism, stiffness, abdominal cramps, nausea, vomiting, headache, tremors, and/or anxiety have been reported. 3,[5][6][7][8] A few patients have hypertension, tachycardia, and/or chest pain.…”

“…1 Myocardial involvement after BWS bites is uncommon, and only a limited number of cases have been recorded with no cases from Egypt. [3][4][5][7][8][9][10]15,16 Here, we report on a 35-year-old previously healthy man who developed myocarditis complicated by acute heart failure and pulmonary edema following a BWS bite, which is the first case reported from Egypt.…”

Toxin-Mediated Myocarditis From a Brown Recluse Spider Bite

“…The two arachnid genera most known in the United States to produce significant morbidity and mortality are Latrodectus (black widow) and Loxosceles (brown recluse). Although black widow–associated myocarditis has been previously described ( 2 , 3 ), we could not identify a prior report of myocarditis due to a brown recluse bite. The clinical syndrome of cutaneous brown recluse spider bite includes a single, small erythematous lesion that develops induration and central necrosis over a span of days ( Figure 7 ).…”