Systemic envenomation caused by the wandering spiderPhoneutria nigriventer, with quantification of circulating venom

Abstract

Introduction. Bites by Phoneutria spp. spiders are common in Brazil, although only 0.5-1% result in severe envenomation, with most of these occurring in children. Cases of systemic envenomation in adults are very unusual, and no serum venom levels have been previously quantified in these cases. Case report. A 52-year-old man was bitten on the neck by an adult female Phoneutria nigriventer. Immediately after the bite, there was intense local pain followed by blurred vision, profuse sweating, tremors, and an episode of vomiting; 1-2 h post bite the patient showed agitation and a blood pressure of 200/130 mmHg, and was given captopril and meperidine. Upon admission to our service 4 h post bite (time zero -T0), his blood pressure was 130/80 mmHg with a heart rate of 150 beats/min, mild tachypnea, agitation, cold extremities, profuse sweating, generalized tremors, and priapism. The patient was treated with antivenom, local anesthetic, and fluid replacement. Most of the systemic manifestations disappeared within 1 h after antivenom. Laboratory blood analyses at T0, T1, T6, T24, and T48 detected circulating venom by ELISA only at T0, before antivenom infusion (47.5 ng/mL; cut-off, 17.1 ng/mL); his serum blood sugar was 163 mg/dL at T0. The patient was discharged on the second day with a normal arterial blood pressure and a follow-up evaluation revealed no sequelae. Conclusion. This is the first report of confirmed moderate/severe envenoming in an adult caused by P. nigriventer with the quantification of circulating venom.

Pharmacological Characterization of the Edema Caused by Vitalius dubius (Theraphosidae, Mygalomorphae) Spider Venom in Rats

“…(Bucaretchi et al, 2000(Bucaretchi et al, , 2008Bucaretchi and Hyslop, 2009) and scorpions (Tityus spp.) (Bucaretchi et al, 2014) in Brazil.…”

Epidemiology of Cardiovascular Toxins

“…Pulmonary edema from spider bites, with potential fatalities, is also rare but has been described. 42,43 Anxiety reactions caused by the fear of widow spiders may confuse the clinical presentation of some patients. It must be remembered that only 1% of widow spider envenomation has life-threating effects.…”

eNOS uncoupling in the cerebellum after BBB disruption by exposure to Phoneutria nigriventer spider venom

“…Accidents graded as severe cause excruciating pain, intense sudoresis, blurred vision, excitotoxic manifestations and priapism, cardiovascular and respiratory distress (Bucaretchi et al, 2000(Bucaretchi et al, , 2008. The venom of P. nigriventer (PNV) contains Ca 2þ , K þ and Na þ channels-acting neuropeptides which affects neurotransmission (Fontana and Vital-Brazil, 1985;Love and Cruz-H€ ofling, 1986;Gomez et al, 2002).…”