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American Journal of Clinical Dermatology Jul 2023Acute generalized exanthematous pustulosis (AGEP) is a rare, acute, severe cutaneous adverse reaction mainly attributed to drugs, although other triggers, including... (Review)
Review
Acute generalized exanthematous pustulosis (AGEP) is a rare, acute, severe cutaneous adverse reaction mainly attributed to drugs, although other triggers, including infections, vaccinations, ingestion of various substances, and spider bites, have also been described. AGEP is characterized by the development of edema and erythema followed by the eruption of multiple punctate, non-follicular, sterile pustules and subsequent desquamation. AGEP typically has a rapid onset and prompt resolution within a few weeks. The differential diagnoses for AGEP are broad and include infectious, inflammatory, and drug-induced etiologies. Diagnosis of AGEP depends on both clinical and histologic criteria, as cases of overlap with other disease processes have been reported. Management includes removal of the offending drug or treatment of the underlying cause, if necessary, and supportive care, as AGEP is a self-limited disease. This review aims to provide an overview and update on the epidemiology, pathogenesis, reported precipitating factors, differentials, diagnosis, and management of AGEP.
Topics: Humans; Acute Generalized Exanthematous Pustulosis; Diagnosis, Differential; Skin; Exanthema; Erythema
PubMed: 37156992
DOI: 10.1007/s40257-023-00779-3 -
Electronic Physician Jul 2017Some of the world's most dangerous spiders have been certified in some areas of Iran. Spider bites are common in some geographical areas, and are sporadic in some...
Some of the world's most dangerous spiders have been certified in some areas of Iran. Spider bites are common in some geographical areas, and are sporadic in some regions. Spider bites can be classified as latrodectism or loxoscelism. If the patient had not seen the spider, the clinical manifestations of latrodectism could be easily mistaken for other types of bite or sting; or an infectious disease, and withdrawal symptoms, and also loxoscelism could be mistaken for cellulitis, various types of skin infection, or even a sting from a Gadim scorpion (). Given the nonspecific presentation of spider bites, one must keep the diagnosis in mind, and question patients, regarding possible exposure to spiders. Physicians recommend becoming familiar with the geographical distribution of Iranian dangerous spiders, clinical manifestations, and management of their bites. The most useful treatment for spider bite is anti-venom administration. Producing spider bite anti-venom in the Razi Vaccine and Serum Research Institute is under investigation.
PubMed: 28894524
DOI: 10.19082/4703 -
American Family Physician Dec 2013The phylum Arthropoda includes arachnids and insects. Although their bites typically cause only local reactions, some species are venomous or transmit disease. The two... (Review)
Review
The phylum Arthropoda includes arachnids and insects. Although their bites typically cause only local reactions, some species are venomous or transmit disease. The two medically important spiders in the United States are widow spiders (Latrodectus), the bite of which causes intense muscle spasms, and the brown recluse (Loxosceles), which may cause skin necrosis. Widow bites usually respond to narcotics, benzodiazepines, or, when necessary, antivenom. Most recluse bites resolve uneventfully without aggressive therapy and require only wound care and minor debridement. Tick bites can transmit diseases only after prolonged attachment to the host. Treatment of clothing with permethrin and proper tick removal greatly reduce the risk of infection. Ticks of medical importance in the United States include the black-legged tick, the Lone Star tick, and the American dog tick. The prophylactic use of a single dose of doxycycline for Lyme disease may be justified in high-risk areas of the country when an attached, engorged black-legged tick is removed. Bites from fleas, bedbugs, biting flies, and mosquitoes present as nonspecific pruritic pink papules, but the history and location of the bite can assist with diagnosis. Flea bites are usually on ankles, whereas mosquito bites are on exposed skin, and chigger bites tend to be along the sock and belt lines. Antihistamines are usually the only treatment required for insect bites; however, severe mosquito reactions (skeeter syndrome) may require prednisone. Applying insect repellent containing diethyltoluamide (DEET) 10% to 35% or picaridin 20% is the best method for preventing bites.
Topics: Animals; Bedbugs; Black Widow Spider; Brown Recluse Spider; Diagnosis, Differential; Diptera; Flea Infestations; Humans; Insect Bites and Stings; Ixodes; Mite Infestations; Spider Bites; Tick Bites; United States
PubMed: 24364549
DOI: No ID Found -
Toxins Jul 2016Spiders and scorpions are notorious for their fearful dispositions and their ability to inject venom into prey and predators, causing symptoms such as necrosis,... (Review)
Review
Spiders and scorpions are notorious for their fearful dispositions and their ability to inject venom into prey and predators, causing symptoms such as necrosis, paralysis, and excruciating pain. Information on venom composition and the toxins present in these species is growing due to an interest in using bioactive toxins from spiders and scorpions for drug discovery purposes and for solving crystal structures of membrane-embedded receptors. Additionally, the identification and isolation of a myriad of spider and scorpion toxins has allowed research within next generation antivenoms to progress at an increasingly faster pace. In this review, the current knowledge of spider and scorpion venoms is presented, followed by a discussion of all published biotechnological efforts within development of spider and scorpion antitoxins based on small molecules, antibodies and fragments thereof, and next generation immunization strategies. The increasing number of discovery and development efforts within this field may point towards an upcoming transition from serum-based antivenoms towards therapeutic solutions based on modern biotechnology.
Topics: Animals; Antivenins; Biotechnology; Computational Biology; Databases, Protein; Drug Discovery; Humans; Scorpion Stings; Scorpion Venoms; Spider Bites; Spider Venoms
PubMed: 27455327
DOI: 10.3390/toxins8080226 -
Texas Medical Journal (Austin, Tex.) Mar 1897
PubMed: 36955849
DOI: No ID Found -
Toxicon : Official Journal of the... Jun 2022We present the case of a 32-year-old male patient hospitalized during the COVID-19 pandemic because of a Brown spider bite on his lower lip. The Brown spider accident...
We present the case of a 32-year-old male patient hospitalized during the COVID-19 pandemic because of a Brown spider bite on his lower lip. The Brown spider accident occurred in southern Brazil; at hospital admission, the patient presented on his lip: edema, pustules, necrotic regions, and ulcerations. The patient complained of lower back pain, fever and dyspnea. Laboratory tests showed monocytosis, leukocytosis, neutrophilia, increased D-dimer levels, C-reactive protein, glutamate-pyruvate transaminase, delta bilirubin, creatine phosphokinase, procalcitonin, and fibrinogen. The patient was hospitalized and a multi-professional team carried out the treatment. The medical team diagnosed loxoscelism with moderate changes. The dentist treated the oral cavity. The patient began to develop nausea, vomiting, and desaturation episodes during hospitalization. A computed tomography of the chest was performed, which showed signs of viral infection. The RT-PCR test for COVID-19 was positive. The systemic conditions worsened (renal dysfunction, systemic inflammatory response, pulmonary complications). This condition may have resulted from the association of the two diseases (loxoscelism and COVID-19), leading to the patient's death. This case illustrates the difficulties and risks in treating patients with venomous animal accidents during the pandemic, and the importance of a multi-professional team in treating such cases.
Topics: Animals; Brown Recluse Spider; COVID-19; Humans; Male; Pandemics; Spider Bites; Spider Venoms; Spiders
PubMed: 35346694
DOI: 10.1016/j.toxicon.2022.03.015 -
American Family Physician Mar 2007There are more than 30,000 species of spiders, most of which cannot inflict serious bites to humans because of their delicate mouthparts and impotent or prey-specific...
There are more than 30,000 species of spiders, most of which cannot inflict serious bites to humans because of their delicate mouthparts and impotent or prey-specific venoms. However, some spiders produce toxic venoms that can cause skin lesions, systemic illnesses, and neurotoxicity. One of the more common bites is inflicted by the widow spiders (Latrodectus species). A bite from a widow spider results in muscle spasms and rigidity starting at the bite site within 30 minutes to two hours. Another common bite is inflicted by the recluse spider (Loxosceles species). Most bites from these spiders occur early in the morning and are initially painless. These bites usually progress to ulcerating dermonecrosis at the bite site. Spider bites can be prevented by simple measures. Early species identification and specific management can prevent most serious sequelae of spider bites.
Topics: Animals; Black Widow Spider; Humans; Spider Bites; Spiders
PubMed: 17390599
DOI: No ID Found -
Toxins Nov 2018Snakes, scorpions, and spiders are venomous animals that pose a threat to human health, and severe envenomings from the bites or stings of these animals must be treated... (Review)
Review
Snakes, scorpions, and spiders are venomous animals that pose a threat to human health, and severe envenomings from the bites or stings of these animals must be treated with antivenom. Current antivenoms are based on plasma-derived immunoglobulins or immunoglobulin fragments from hyper-immunized animals. Although these medicines have been life-saving for more than 120 years, opportunities to improve envenoming therapy exist. In the later decades, new biotechnological tools have been applied with the aim of improving the efficacy, safety, and affordability of antivenoms. Within the avenues explored, novel immunization strategies using synthetic peptide epitopes, recombinant toxins (or toxoids), or DNA strings as immunogens have demonstrated potential for generating antivenoms with high therapeutic antibody titers and broad neutralizing capacity. Furthermore, these approaches circumvent the need for venom in the production process of antivenoms, thereby limiting some of the complications associated with animal captivity and venom collection. Finally, an important benefit of innovative immunization approaches is that they are often compatible with existing antivenom manufacturing setups. In this review, we compile all reported studies examining venom-independent innovative immunization strategies for antivenom development. In addition, a brief description of toxin families of medical relevance found in snake, scorpion, and spider venoms is presented, as well as how biochemical, bioinformatic, and omics tools could aid the development of next-generation antivenoms.
Topics: Animals; Antivenins; Humans; Snake Bites; Snake Venoms; Spider Bites; Spider Venoms
PubMed: 30400220
DOI: 10.3390/toxins10110452 -
Cureus Dec 2022Spider bites, while rarely confirmed beyond a doubt, should always be in the differential for any severe symptoms or infection out of proportion to presentation with the...
Spider bites, while rarely confirmed beyond a doubt, should always be in the differential for any severe symptoms or infection out of proportion to presentation with the suspected presence of appropriate vectors. While most arthropod bites will only result in mild localized irritation, the potential to cause severe cutaneous and systemic effects should not be overlooked. We present one such case, in which a presumed brown recluse () bite on the neck resulted in severe illness with systemic manifestations. The patient presented to the emergency room minimally responsive with left-sided facial nerve palsy and septic shock. While the admitting physician initially prioritized stabilizing the patient, he noted the left-sided cervical cellulitis. Thorough history taking revealed that the patient had been worsening since being bitten by a spider three days prior to admission. After a month-long hospital stay and multidisciplinary treatment, the patient was transferred to a larger center with facial paralysis still present.
PubMed: 36601209
DOI: 10.7759/cureus.32162