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Infestations and Bites
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Loxosceles spiders have a worldwide distribution but are most heavily concentrated in the western hemisphere, often in a domestic habitat where they hide in crevices, within cardboard, or behind furnishings. In the United States, spider bites east of the Mississippi River are not as dangerous because the destructive black widow spider resides west of the Mississippi. These spiders may be distinguished by their characteristic red or orange fiddle-back pattern displayed on their ventral (underside) surface.
Workers’ Compensation Case Evaluation
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
An employee reports to work on Monday morning and tells the supervisor of a spider bite that occurred while at work the previous Friday afternoon. Upon questioning, the employee reports the first notice of the “spider bite” was on Saturday morning, and today the area has become more painful and red. Although a spider was not actually seen, the employee assumes the lesion is a “spider bite” that occurred last Friday when removing debris from the worksite. The employer writes up an injury report, submits a worker’s compensation claim, and sends the injured worker to the Emergency Department (ED), where the injured worker receives a prescription for antibiotics and an out-of-work note for five days. The ED discharge orders state the employee is to be re-evaluated by a primary care physician in five days. Two days later, the employee becomes very ill and is admitted to the hospital for incision and drainage of an infected wound.
Bites and burns
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Faisal G Qureshi, Felix C Blanco, Kurt D Newman
From the list above, select the correct diagnosis for the following scenarios. During a camping trip, a 5-year-old child experiences double vision, bronchospasm, excessive salivation and muscle cramps. He is taken to the emergency room where the physician detects a small puncture wound in the hand that looks like an insect bite. What is the most appropriate management?Four days after suffering a spider bite, a 3-year-old girl is brought to the paediatrician for a deep ulcer at the bite site. What is the diagnosis?A 10-year-old boy sustained a spider bite while sleeping at home. A few hours later, he has autonomic hyperactivity, painful muscle spasms and priapism. What is the diagnosis?
Systemic loxoscelism induced warm autoimmune hemolytic anemia: clinical series and review
Published in Hematology, 2022
Brandon Calhoun, Andrew Moore, Andrew Dickey, D. Matthew Shoemaker
The brown recluse spider, Loxosceles reclusa, is typically characterized as a burnt orange to tan-colored arthropod, approximately 25 mm in diameter (Figure 2) [1]. A characteristic feature of L. reclusa is a dark brown violin-shaped mark on the spider’s back (Figure 2) [1]. L. reclusa is most commonly found within the Central Midwest to Southeastern and Southwestern regions of the U.S, with the highest population of L. reclusa located within Texas, Illinois, and Missouri (Figure 3) [2]. According to the 2019 Annual Report of the American Association of Poison Control Centers, of the 4263 total spider bites, 802 were reported to do due to L. reclusa [3]. Of the 802 envenomations, 148 suffered minor outcomes, 174 people suffered moderate outcomes, 24 suffered major outcomes, but no deaths were reported [3]. However, Williams et al. concluded that from 1958 to 1995, approximately eight individual cases resulted in death due to systemic loxoscelism, likely secondary to acute kidney injury or disseminated intravascular coagulation [4]. 17 cases of life-threatening L. reclusa induced hemolysis were reported between the years of 2003 and 2013, all of which occurred in children under the age of 18 and all in the Nashville, Tennessee area [5].
Is there actual clinical evidence of necrosis following the Steatoda nobilis bite?
Published in Clinical Toxicology, 2022
Giovanni Paolino, Piergiorgio Di Pompeo, Matteo R. Di Nicola
The venom of S. nobilis is mainly characterized by α-latrotoxins, δ-latroinsectotoxins, latrodectins and enzymes [2], which explains both systemic and local clinical signs, like ulceration and erosion. Necrosis is an inappropriate term referring to a spectrum of morphologic changes that follow cell death in tissues, and it is divisible in six main types: coagulative, liquefactive, caseous, gangrenous, fat and fibrinoid necrosis [3]. Gangrenous necrosis is the one mainly involved in spider bites, as it is induced mostly by proteolytic enzymes that cause cell death (e.g., sphingomyelinase in Loxosceles sp.) [4]. Necrosis induced by spider bites clinically shows specific and progressive pathognomonic aspects, such as prodromal swelling and blisters, followed by a cutaneous discoloration ranging from pale to blue, purple, black, bronze or red. The damaged tissue develops into dark black color, always resulting in a clinically evident scar due to dermal and hypodermic damage.
Black widow spider bite in Johannesburg
Published in Southern African Journal of Infectious Diseases, 2018
Teressa Sumy Thomas, Alan Kemp, Kim Pieton Roberg
Clinical features may be difficult to recognise and a high index of suspicion is required to make the diagnosis. A bite mark is unusual and is found in less than 30% of cases. It is typical to find redness and local inflammation around the bite site, if found. Suspicion of a spider bite is thus dependant on features of latrodectism, which include typical symptoms such as a burning pain at the bite site which immediately spreads to the regional lymph nodes and then leads to generalised muscle cramps within an hour.2 Increased muscle tone can be evident clinically. This increased tone may be interpreted as a tightness in the chest with difficulty in breathing, board-like abdominal rigidity mimicking an acute abdomen, difficulty in walking or the presence of an erection.1 Nausea and vomiting may occur. Vitals signs may reveal a raised blood pressure, heart rate and temperature with sweating, anxiety and flushing (usually facial and periorbitally). Envenomation can be classified as mild, moderate or severe. Mild includes local pain and redness at the site only, moderate being local cramping and sweating in the extremity involved and severe being systemic symptoms with tachycardia and high blood pressure.4