Document Detail


Systemic envenomation caused by the wandering spider Phoneutria nigriventer, with quantification of circulating venom.
MedLine Citation:
PMID:  18788004     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Fábio Bucaretchi; Sueli Moreira Mello; Ronan José Vieira; Ronei Luciano Mamoni; Maria Heloísa Souza Lima Blotta; Edson Antunes; Stephen Hyslop
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical toxicology (Philadelphia, Pa.)     Volume:  46     ISSN:  1556-9519     ISO Abbreviation:  Clin Toxicol (Phila)     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-12     Completed Date:  2008-12-01     Revised Date:  2009-11-17    
Medline Journal Info:
Nlm Unique ID:  101241654     Medline TA:  Clin Toxicol (Phila)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  885-9     Citation Subset:  AIM; IM    
Affiliation:
Pediatrics, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil. bucaret@fcm.unicamp.br
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Local / therapeutic use
Animals
Antivenins / therapeutic use*
Arachnidism / drug therapy,  physiopathology*
Brazil / epidemiology
Captopril / therapeutic use
Enzyme-Linked Immunosorbent Assay
Female
Follow-Up Studies
Humans
Hypertension / etiology
Male
Meperidine / therapeutic use
Middle Aged
Spider Venoms / pharmacokinetics,  poisoning*
Spiders
Time Factors
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 0/Antivenins; 0/Spider Venoms; 57-42-1/Meperidine; 62571-86-2/Captopril

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