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[Neurotoxic manifestations of black widow spider envenomation in paediatric patients].
Neurologia 2016; 31(4):215-22N

Abstract

INTRODUCTION

Envenomation by black widow spiders manifests clinically with signs of neurotoxicity in paediatric patients.

OBJECTIVE

Identify typical neurological signs and symptoms in paediatric patients of different ages, and describe treatment and outcomes in a paediatric hospital in northwest Mexico.

MATERIAL AND METHODS

We reviewed 70 clinical records of patients hospitalised due to black widow spider bite between 1978 and 2014. We divided the total into 2 groups: Group 1, infants and preschool children; and Group 2, school-age children and adolescents. The demographic variables were age, sex, birthplace, place where envenomation occurred, body part(s) affected, degree of envenomation according to signs and symptoms, treatment, clinical outcome, and statistical differences.

RESULTS

Boys accounted for 61.4% of all cases, and infants younger than one year old made up 14.2%. Most patients (70%) were bitten by the spider at home; the anatomical areas most frequently affected were the legs, neck, thorax, and abdomen. The neurological signs and symptoms displayed by Group 1 were irritability, constant crying, sialorrhoea, nausea, tachycardia, arrhythmias, fatigue when walking, agitation, muscle spasms paraesthesia, tetany, seizures, and nystagmus. Signs in Group 2 included localized pain, headache, sialorrhoea, paraesthesia, profuse sweating, anxiety, muscle weakness, muscle spasms, and fine tremor. The predominant autonomic sign in Group 1 was sialorrhoea (P<.0001) and in Group 2, paraesthesia (P<.0001). Patients who received Fab antivenom treatment displayed better outcomes and shorter hospital stays than those who did not. No deaths were reported.

CONCLUSIONS

The neurological signs and symptoms caused by black widow spider bite are predominantly autonomic, and identifying them permits early diagnosis and more effective treatment.

Authors+Show Affiliations

Departamento de Medicina y Ciencias de la Salud, Universidad de Sonora, Hospital Infantil del Estado de Sonora, Hermosillo, Mexico. Electronic address: nsotelo51@gmail.com.Servicio de Urgencias Pediátricas, Hospital Infantil del Estado de Sonora, Hermosillo, Mexico.

Pub Type(s)

Journal Article

Language

spa

PubMed ID

26304660

Citation

Sotelo-Cruz, N, and N Gómez-Rivera. "[Neurotoxic Manifestations of Black Widow Spider Envenomation in Paediatric Patients]." Neurologia (Barcelona, Spain), vol. 31, no. 4, 2016, pp. 215-22.
Sotelo-Cruz N, Gómez-Rivera N. [Neurotoxic manifestations of black widow spider envenomation in paediatric patients]. Neurologia. 2016;31(4):215-22.
Sotelo-Cruz, N., & Gómez-Rivera, N. (2016). [Neurotoxic manifestations of black widow spider envenomation in paediatric patients]. Neurologia (Barcelona, Spain), 31(4), pp. 215-22. doi:10.1016/j.nrl.2015.05.007.
Sotelo-Cruz N, Gómez-Rivera N. [Neurotoxic Manifestations of Black Widow Spider Envenomation in Paediatric Patients]. Neurologia. 2016;31(4):215-22. PubMed PMID: 26304660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Neurotoxic manifestations of black widow spider envenomation in paediatric patients]. AU - Sotelo-Cruz,N, AU - Gómez-Rivera,N, Y1 - 2015/08/21/ PY - 2015/02/05/received PY - 2015/05/13/revised PY - 2015/05/25/accepted PY - 2015/8/26/entrez PY - 2015/8/26/pubmed PY - 2017/2/24/medline KW - Antivenenos faboterápicos KW - Black widow spider KW - Envenenamiento KW - Envenomation KW - Fab antivenom KW - Latrodectus mactans KW - Neurological signs KW - Signos neurológicos KW - «Araña viuda negra» SP - 215 EP - 22 JF - Neurologia (Barcelona, Spain) JO - Neurologia VL - 31 IS - 4 N2 - INTRODUCTION: Envenomation by black widow spiders manifests clinically with signs of neurotoxicity in paediatric patients. OBJECTIVE: Identify typical neurological signs and symptoms in paediatric patients of different ages, and describe treatment and outcomes in a paediatric hospital in northwest Mexico. MATERIAL AND METHODS: We reviewed 70 clinical records of patients hospitalised due to black widow spider bite between 1978 and 2014. We divided the total into 2 groups: Group 1, infants and preschool children; and Group 2, school-age children and adolescents. The demographic variables were age, sex, birthplace, place where envenomation occurred, body part(s) affected, degree of envenomation according to signs and symptoms, treatment, clinical outcome, and statistical differences. RESULTS: Boys accounted for 61.4% of all cases, and infants younger than one year old made up 14.2%. Most patients (70%) were bitten by the spider at home; the anatomical areas most frequently affected were the legs, neck, thorax, and abdomen. The neurological signs and symptoms displayed by Group 1 were irritability, constant crying, sialorrhoea, nausea, tachycardia, arrhythmias, fatigue when walking, agitation, muscle spasms paraesthesia, tetany, seizures, and nystagmus. Signs in Group 2 included localized pain, headache, sialorrhoea, paraesthesia, profuse sweating, anxiety, muscle weakness, muscle spasms, and fine tremor. The predominant autonomic sign in Group 1 was sialorrhoea (P<.0001) and in Group 2, paraesthesia (P<.0001). Patients who received Fab antivenom treatment displayed better outcomes and shorter hospital stays than those who did not. No deaths were reported. CONCLUSIONS: The neurological signs and symptoms caused by black widow spider bite are predominantly autonomic, and identifying them permits early diagnosis and more effective treatment. SN - 1578-1968 UR - https://www.unboundmedicine.com/medline/citation/26304660/[Neurotoxic_manifestations_of_black_widow_spider_envenomation_in_paediatric_patients]_ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0213-4853(15)00150-4 DB - PRIME DP - Unbound Medicine ER -