Discipline of Clinical Pharmacology, University of Newcastle, Newcastle, NSW, Australia; Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle, NSW, Australia.
Centro de Desenvolvimento Cultural, Instituto Butantan, São Paulo, Brazil.
Lancet. 2011 Dec 10;378(9808):2039-2047. doi: 10.1016/S0140-6736(10)62230-1. Epub 2011 Jul 15.
Spiders are a source of intrigue and fear, and several myths exist about their medical effects. Many people believe that bites from various spider species cause necrotic ulceration, despite evidence that most suspected cases of necrotic arachnidism are caused by something other than a spider bite. Latrodectism and loxoscelism are the most important clinical syndromes resulting from spider bite. Latrodectism results from bites by widow spiders (Latrodectus spp) and causes local, regional, or generalised pain associated with non-specific symptoms and autonomic effects. Loxoscelism is caused by Loxosceles spp, and the cutaneous form manifests as pain and erythema that can develop into a necrotic ulcer. Systemic loxoscelism is characterised by intravascular haemolysis and renal failure on occasion. Other important spiders include the Australian funnel-web spider (Atrax spp and Hadronyche spp) and the armed spider (Phoneutria spp) from Brazil. Antivenoms are an important treatment for spider envenomation but have been less successful than have those for snake envenomation, with concerns about their effectiveness for both latrodectism and loxoscelism.
蜘蛛是一个充满好奇和恐惧的来源，关于它们对医学影响的传说有很多。尽管有证据表明，大多数疑似坏死性蛛形纲动物病的病例并非由蜘蛛咬伤引起，但许多人仍然认为，各种蜘蛛物种的咬伤会导致坏死性溃疡。蛛形纲动物咬伤和狼蛛咬伤是由蜘蛛咬伤引起的最重要的临床综合征。蛛形纲动物咬伤是由寡妇蛛（Latrodectus spp）咬伤引起的，会导致局部、区域或全身性疼痛，并伴有非特异性症状和自主神经效应。狼蛛病是由狼蛛引起的，皮肤形式表现为疼痛和红斑，可发展成坏死性溃疡。系统性狼蛛病的特征是偶尔发生血管内溶血和肾衰竭。其他重要的蜘蛛包括澳大利亚漏斗网蜘蛛（Atrax spp 和 Hadronyche spp）和来自巴西的武装蜘蛛（Phoneutria spp）。抗蛇毒血清是治疗蜘蛛咬伤的重要方法，但效果不如抗蛇毒血清好，人们对其治疗狼蛛咬伤和狼蛛咬伤的效果存在担忧。
