Faculty of Medical Sciences, State University of Campinas, Campinas Poison Control Center, Campinas, Brazil.
Clin Toxicol (Phila). 2010 Aug;48(7):764-5. doi: 10.3109/15563650.2010.502123.
A previously healthy 35-year-old female was bitten on the anterior right thigh by a brown spider while dressing her trousers; the spider was stored and later identified as an adult female Loxosceles anomala. Clinical evolution involved a relatively painless bite with mild itching, followed by local, indurated swelling and a transient, generalized erythrodermic rash at 24 h post-bite. The local discomfort was progressive, and involved changes in the lesion pattern, with pain of increasing intensity. The patient was admitted 60 h post-bite, showing an irregular blue plaque surrounded by an erythematous halo lesion, located over an area of indurated swelling. Considering the presumptive diagnosis of cutaneous loxoscelism, she was treated with five vials of anti-arachnidic antivenom i.v. without adverse effects. There was progressive improvement, with no dermonecrosis or hemolysis; complete lesion healing was observed by Day 55. The clinical features and outcome were compatible with cutaneous loxoscelism and similar to those reported for other Loxosceles species.
一位 35 岁既往健康的女性在穿裤子时被一只棕色蜘蛛咬伤右大腿前侧，该蜘蛛被保存并经鉴定为成年雌性 Loxosceles anomala。临床演变过程为相对无痛的咬伤伴轻度瘙痒，随后在咬伤后 24 小时出现局部硬结性肿胀和短暂的全身性红皮病疹。局部不适逐渐加重，伴有病变模式的变化，疼痛程度逐渐增加。患者在咬伤后 60 小时入院，表现为不规则蓝色斑块，周围有红斑性晕环病变，位于硬结性肿胀区域。考虑到疑似皮肤利什曼病的诊断，她接受了五瓶静脉注射抗蛛毒血清治疗，无不良反应。病情逐渐改善，无皮肤坏死或溶血；第 55 天观察到完全的病变愈合。临床特征和结局与皮肤利什曼病相符，与其他 Loxosceles 物种的报告相似。
