la Barra Paula de, Vial Verónica, Labraña Yenis, Álvarez Ana María, Seguel Helena
Rev Chilena Infectol. 2015 Aug;32(4):467-71. doi: 10.4067/S0716-10182015000500017.
In Chile, loxoscelism is caused by the bite of the Loxosceles laeta spider. The clinical presentation has two different forms: cutaneous loxoscelism (CL) and vicero-cutaneous loxoscelism, which is less frequent. Cutaneous loxoscelism includes an uncommon clinical variation (4%), called CL with edematous predominance (CLEP). We present a 5-year-old patient with sudden pain and edema on his right eyelid associated with fever, which progressed rapidly involving the right hemifacial area, frontal region, and left eyelid. Angioedema and pre-orbital cellulitis were discarded and CLEP was suspect. Cutaneous loxoscelism with an edematous predominance is self-limited, benign and with little or no necrotic injury due to the edema, which dilutes the toxin-induced enzymatic process causing necrosis. As in the reported cases it usually responds well to medical treatment and does not cause visceral involvement.
在智利，脂蛛中毒是由南美褐蛛（Loxosceles laeta）的叮咬引起的。临床表现有两种不同形式：皮肤型脂蛛中毒（CL）和内脏皮肤型脂蛛中毒，后者较为少见。皮肤型脂蛛中毒包括一种不常见的临床变异类型（4%），称为以水肿为主的皮肤型脂蛛中毒（CLEP）。我们报告一名5岁患者，其右眼睑突然出现疼痛和水肿，并伴有发热，迅速发展至累及右侧面部、额部区域及左侧眼睑。排除了血管性水肿和眶前蜂窝织炎，怀疑为CLEP。以水肿为主的皮肤型脂蛛中毒具有自限性、良性，且因水肿导致毒素诱导的酶促坏死过程稀释，几乎没有或仅有轻微坏死损伤。正如报道的病例所示，它通常对药物治疗反应良好，不会引起内脏受累。
