Elbahlawan Lama M, Stidham Gregory L, Bugnitz Mark C, Storgion Stephanie A, Quasney Michael W
Division of Critical Care, Department of Pediatrics, University of Tennessee, and the Children's Foundation of Memphis Research Center, Memphis, TN 38103, USA.
Pediatr Emerg Care. 2005 Mar;21(3):177-80.
To report 6 children who had severe systemic reaction after spider bites requiring pediatric intensive care unit admission and to describe their clinical presentation, hospital course, and outcome.
A retrospective analysis was done to identify patients presenting with brown recluse spider bites. Charts of children admitted to the intensive care unit were reviewed.
Six previously healthy African-American children, aged 3 to 15 years, with brown recluse spider bites were admitted to the pediatric intensive care unit. All had fever, jaundice, and evidence of hemolytic anemia. Four of 6 children had hypotension. One child developed mental status changes, acute renal failure secondary to rhabdomyolysis, and hyperkalemia and required emergent hemodialysis. All children fully recovered.
Although most cases of brown recluse spider bites are benign requiring no intervention, severe systemic reactions may occur in the pediatric population resulting in admission to the pediatric intensive care unit. These systemic reactions may include hemolytic anemia, hypotension, and renal failure.
报告6例蜘蛛叮咬后出现严重全身反应需入住儿科重症监护病房的儿童病例，并描述其临床表现、住院过程及结局。
进行回顾性分析以确定出现棕色遁蛛叮咬的患者。对入住重症监护病房的儿童病历进行了审查。
6名先前健康的非裔美国儿童，年龄在3至15岁之间，因棕色遁蛛叮咬入住儿科重症监护病房。所有患儿均有发热、黄疸及溶血性贫血的证据。6名儿童中有4名出现低血压。1名儿童出现精神状态改变、横纹肌溶解继发急性肾衰竭及高钾血症，需要紧急血液透析。所有儿童均完全康复。
尽管大多数棕色遁蛛叮咬病例为良性，无需干预，但儿科人群中可能会发生严重的全身反应，导致入住儿科重症监护病房。这些全身反应可能包括溶血性贫血、低血压和肾衰竭。
