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Academic Emergency Medicine : Official... Feb 2011
Topics: Attitude of Health Personnel; Blood Transfusion; Child, Preschool; Emergency Service, Hospital; Fatal Outcome; Female; Hemolysis; Humans; Phosphoric Diester Hydrolases; Spider Bites; Spider Venoms
PubMed: 21314786
DOI: 10.1111/j.1553-2712.2010.00999.x -
The Journal of Clinical and Aesthetic... Mar 2013Triazole antifungals are commonly used in the treatment of oral, esophageal, and vaginal candidiasis. Fluconazole is frequently prescribed as the therapy modality for...
Triazole antifungals are commonly used in the treatment of oral, esophageal, and vaginal candidiasis. Fluconazole is frequently prescribed as the therapy modality for vaginal fungal infections. On rare occasions, fluconazole has been shown to cause fixed drug eruptions. Lesions of fixed drug eruptions vary in size and number, but have the same general appearance and symptoms. The authors report a case of fluconazole-induced fixed drug eruption in a 24-year-old woman with recurrent vaginal candidiasis. The lesion was initially diagnosed as a spider bite. Topical and oral provocation tests with fluconazole were performed. Topical provocation with petroleum/fluconazole and dimethyl sulfoxide/fluonazole were both negative. Oral provocation was positive, thus confirming the diagnosis of fluconazole-induced fixed drug eruption.
PubMed: 23556037
DOI: No ID Found -
JPRAS Open Sep 2024Breast reconstruction following mastectomy is a critical component of breast cancer treatment, aimed at improving patient quality of life. However, the management is...
BACKGROUND
Breast reconstruction following mastectomy is a critical component of breast cancer treatment, aimed at improving patient quality of life. However, the management is fraught with potential complications, including skin necrosis and wound dehiscence, which can significantly impact clinical outcomes.
CASE PRESENTATION
We report a unique case of a patient, 5 years post-breast reconstruction following mastectomy and radiation therapy, who developed severe skin necrosis and wound dehiscence due to a brown recluse spider bite on the reconstructed breast. The complication necessitated the debridement of skin, removal of the implant, and further reconstruction with a latissimus flap.
DISCUSSION
The case underscores the unusual etiology of spider bite-induced necrosis in breast reconstruction and highlights the challenges and strategic considerations in managing such complications. Upon presentation, the patient's affected breast area showed signs of extensive necrosis and wound dehiscence, directly attributed to the cytotoxic effects of the brown recluse spider's venom. The venom's pathophysiology involves a complex cascade, leading to local and systemic effects. The local effects, marked by dermonecrosis, com- promised skin integrity in this instance. Systemic effects, not observed in this patient but potentially severe, can include hemolysis, coagulopathy, and acute renal failure, highlighting the seriousness of brown recluse spider bites.
CONCLUSION
In conclusion, this case illustrates the complexities of managing breast reconstruction post-mastectomy complications, particularly those caused by external factors such as brown recluse spider bites. It highlights the need for meticulous attention to unusual etiologies of necrosis and dehiscence, demonstrating the importance of adaptable surgical strategies and a thorough understanding of venom pathophysiology in ensuring successful patient outcomes.
PubMed: 38911670
DOI: 10.1016/j.jpra.2024.05.008 -
Microbiology Spectrum Jun 2022Animal venoms are considered sterile sources of antimicrobial compounds with strong membrane-disrupting activity against multidrug-resistant bacteria. However, venomous...
Animal venoms are considered sterile sources of antimicrobial compounds with strong membrane-disrupting activity against multidrug-resistant bacteria. However, venomous bite wound infections are common in developing nations. Investigating the envenomation organ and venom microbiota of five snake and two spider species, we observed venom community structures that depend on the host venomous animal species and evidenced recovery of viable microorganisms from black-necked spitting cobra (Naja nigricollis) and Indian ornamental tarantula (Poecilotheria regalis) venoms. Among the bacterial isolates recovered from , we identified two venom-resistant, novel sequence types of Enterococcus faecalis whose genomes feature 16 virulence genes, indicating infectious potential, and 45 additional genes, nearly half of which improve bacterial membrane integrity. Our findings challenge the dogma of venom sterility and indicate an increased primary infection risk in the clinical management of venomous animal bite wounds. Notwithstanding their 3 to 5% mortality, the 2.7 million envenomation-related injuries occurring annually-predominantly across Africa, Asia, and Latin America-are also major causes of morbidity. Venom toxin-damaged tissue will develop infections in some 75% of envenomation victims, with E. faecalis being a common culprit of disease; however, such infections are generally considered to be independent of envenomation. Here, we provide evidence on venom microbiota across snakes and arachnida and report on the convergent evolution mechanisms that can facilitate adaptation to black-necked cobra venom in two independent E. faecalis strains, easily misidentified by biochemical diagnostics. Therefore, since inoculation with viable and virulence gene-harboring bacteria can occur during envenomation, acute infection risk management following envenomation is warranted, particularly for immunocompromised and malnourished victims in resource-limited settings. These results shed light on how bacteria evolve for survival in one of the most extreme environments on Earth and how venomous bites must be also treated for infections.
Topics: Animals; Arachnida; Asia; Bacteria; Snakes; Venoms
PubMed: 35604233
DOI: 10.1128/spectrum.02408-21 -
Revista Medica de Chile May 2021Loxoscelism is an important public health problem in Chile and South America, due to the higher rate of cutaneous-visceral involvement. The diagnosis of loxoscelism is...
BACKGROUND
Loxoscelism is an important public health problem in Chile and South America, due to the higher rate of cutaneous-visceral involvement. The diagnosis of loxoscelism is mostly clinical without established diagnostic criteria. There is little evidence to support any treatment used in this condition.
AIM
To characterize the clinical features and epidemiology of loxoscelism among patients consulting at the Emergency and Dermatology Services of a clinical hospital between 2013 and 2017.
MATERIAL AND METHODS
Review of medical records of patients registered in the electronic clinical record system with a confirmed diagnosis of loxoscelism. Epidemiological, clinical, laboratory tests and treatment variables were analyzed.
RESULTS
We reviewed data from 200 patients. Ninety-four percent presented cutaneous loxoscelism and 5.5% cutaneous-visceral loxoscelism. Systemic symptoms were present in 73% of patients with cutaneous-visceral loxoscelism. Patients who developed systemic symptoms had an 18 times higher risk of developing cutaneous-visceral loxoscelism. Laboratory abnormalities were more common in patients with cutaneous-visceral loxoscelism. Not all patients with hematuria had cutaneous-visceral loxoscelism. Most patients required analgesia. Anti-loxosceles serum was not used in any patient.
CONCLUSIONS
Many questions remain to be answered regarding the diagnosis and treatment of the disease. Studies are required to validate diagnostic criteria for loxoscelism, predictors for visceral involvement and response to treatment.
Topics: Animals; Chile; Humans; Pain; Spider Bites; Spider Venoms; Spiders
PubMed: 34751320
DOI: 10.4067/s0034-98872021000500682 -
PeerJ 2020The is a species of theraphosid spider from China. Its large size and charming appearance make this species a popular pet. According to a previous study, theraphosid...
The is a species of theraphosid spider from China. Its large size and charming appearance make this species a popular pet. According to a previous study, theraphosid spider bites can induce pain, erythema, and edema in humans and can present more severely in domestic animals. The pathological consequences of envenomation by remain unclear. In this study, we investigated the effects and mechanisms of envenomation in mice. We showed that the venom induced slight swelling, intense inflammatory response, and increased the microvascular density in mice skin. Moreover, we found that 50 µg/ml of the spider's venom induced IL-1β expression in both HaCaT cells and fibroblast cells, but repressed CXCL10 expression in fibroblasts. The venom significantly induced cell senescence and repressed cell proliferation and migration in both HaCaT cells and fibroblast cells. Finally, we examined the expression of Nav channel in HaCaT and fibroblast cells and found that venom effectively inhibited Na currents in HaCaT cells. Our study calls for further investigation of the pathological consequences and potential mechanisms of envenomation. This information might assist in the development of suitable therapy.
PubMed: 31942253
DOI: 10.7717/peerj.8264 -
Dermatology Online Journal Nov 1999The brown recluse spider, Loxosceles reclusa, is often implicated as a cause of necrotic skin lesions.[1-3] Diagnoses are most commonly made by clinical appearance and... (Review)
Review
The brown recluse spider, Loxosceles reclusa, is often implicated as a cause of necrotic skin lesions.[1-3] Diagnoses are most commonly made by clinical appearance and infrequently is a spider seen, captured or identified at the time of the bite.[1, 2, 4-6] The brown recluse lives in a circumscribed area of the U.S. (the south central Midwest) with a few less common recluse species living in the more sparsely-populated southwest U.S.[7] In these areas, where spider populations may be dense, recluse spiders may be a cause of significant morbidity. However, outside the natural range of these recluse species, the conviction that they are the etiological agents behind necrotic lesions of unknown origin is widespread, and most often erroneous. In some states such as California, unsubstantiated reports concerning recluse spider bites have taken on the status of "urban legend" leading to overdiagnosis and, therefore, inappropriate treatment.
Topics: Animals; Diagnostic Errors; Necrosis; Spider Bites; Spiders; United States
PubMed: 10673460
DOI: No ID Found -
Cardiology and Therapy Dec 2020The black widow spider (BWS) is a venomous spider whose bite can cause various clinical conditions that range from local damage to serious systemic complications,...
The black widow spider (BWS) is a venomous spider whose bite can cause various clinical conditions that range from local damage to serious systemic complications, including death. Cases of myocarditis following a BWS bite are rare but they can be fatal on occasion. However, the prognostic significance of the bite and presentation of myocarditis is unknown. Our case involved a 50-year-old man who presented with myocarditis after being bitten by a BWS and subsequently admitted to the intensive care unit for cardiac monitoring. During the hospital stay, he showed worsening signs on both the electrocardiographic and echocardiographic evaluations despite therapeutic success. Subsequent cardiac magnetic resonance and coronary angiography investigations showed no significant alterations; blood and instrumental test results slowly improved, and the patient was discharged home after 12 days of hospitalization without complications. This case illustrates that acute myocarditis, although an infrequent complication of BWS bite, has the potential to be lethal. The correct diagnosis, which is not always easy to formulate, is important to identify those patients who can benefit from careful monitoring and specific therapies aimed at reducing the risk of life.
PubMed: 32462634
DOI: 10.1007/s40119-020-00178-3 -
The Journal of International Medical... Aug 2023A brown recluse spider (BRS) bite is challenging to confirm, but may be clinically diagnosed by considering the location, the season of the year, and the clinical... (Review)
Review
A brown recluse spider (BRS) bite is challenging to confirm, but may be clinically diagnosed by considering the location, the season of the year, and the clinical manifestations. Here, the case of a 26-year-old male who presented after an insect bite with a skin lesion, bruising, severe swelling, and diffuse blisters on the right lower extremity after three days, is described. Following clinical examination, patient history assessment, and consideration of other relevant factors, the patient received a differential diagnosis of necrotizing fasciitis caused by BRS bite. Although spider bite poisoning is rare, proper diagnosis and management are important because, in some cases, the outcomes may be devastating.
Topics: Male; Animals; Brown Recluse Spider; Spider Bites; Skin Diseases; Fasciitis, Necrotizing; Diagnosis, Differential
PubMed: 37565672
DOI: 10.1177/03000605231157284 -
Journal of Pediatric Hematology/oncology Jan 2019Brown recluse spider bites can cause local and systemic signs, including rash, dermonecrosis, edema, hemolysis, and acute kidney failure. These are mostly attributed to... (Clinical Trial)
Clinical Trial
Brown recluse spider bites can cause local and systemic signs, including rash, dermonecrosis, edema, hemolysis, and acute kidney failure. These are mostly attributed to sphingomyelinase D, the main toxin. To evaluate the severity of the disease in pediatric patients with and without neutropenia, we retrospectively reviewed records of patients treated at St. Jude Children's Research Hospital between 1970 and 2015 and identified 19 patients who met the inclusion criteria. Variables of interest included the type of underlying illness, presence of neutropenia, number of days of hospitalization, disease signs and outcome of the bite, and treatments administered. We used descriptive statistics to summarize the manifestations and severity of spider bites in patients with and without neutropenia. Six patients experienced pain from the bite, 11 had erythema, 7 developed edema, and 5 had fever. The response to spider bites in neutropenic patients was no milder than that in non-neutropenic individuals. Six patients developed systemic complications. Compared with non-neutropenic patients, neutropenic patients had antibiotics prescribed more often and experienced longer hospital stays. Spider bites do not seem to have a different clinical course in neutropenic patients. Therefore, a conservative approach may be best for these patients, with close monitoring and local wound care.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Male; Neoplasms; Neutropenia; Retrospective Studies; Severity of Illness Index; Spider Bites
PubMed: 30028826
DOI: 10.1097/MPH.0000000000001253