Díez García F, Laynez Bretones F, Gálvez Contreras M C, Mohd H, Collado Romacho A, Yélamos Rodríguez F
Servicio de Medicina Interna, Hospital Torrecárdenas, Almería.
Med Clin (Barc). 1996 Mar 9;106(9):344-6.
The most severe cases of arachnidism are those due to Latrodectus tredecimguttatus spider-bite. The Mediterranean area is the habitat of the L. tredecimguttatus species. In the last few years no series of patients with latrodectism has been reported in Spain. A retrospective study of the patients admitted for L. tredecimguttatus spider bite in the Torrecárdenas Hospital in Almeria, Spain from 1984 to 1994 was performed. Twelve patients were diagnosed with latrodectism. Eleven were bitten while carrying out agricultural tasks, 8 of which were performed in greenhouses. The mean time between the bite and the appearance of the general symptoms was 40 minutes (20-120 minutes), with the most common signs and symptoms being: pain and abdominal stiffness (10 cases), erythema (10 cases) or pain (8 cases) at the site of the bite, thoracic pain, pain in extremities and contractures and psychomotor alterations (6 cases). Laboratory findings were limited to leukocytosis (4 cases), increase in creatinphosphokinase count (4 cases) and proteinuria (3 cases). All the patients received analgesics, 6 were administered myorelaxants and calcium gluconate was given in 6 cases. The evolution was good without complications in all of the patients. Latrodectism is a rare phenomenon Spain. The diagnosis is difficult when there is absence of a clear history of spider bite and due to the lack of knowledge as to its semiology. Antivenom serum is not usually required.
最严重的蛛毒中毒病例是由红斑寇蛛咬伤所致。地中海地区是红斑寇蛛的栖息地。在过去几年里,西班牙没有关于蛛毒中毒患者系列病例的报道。对1984年至1994年期间在西班牙阿尔梅里亚省托雷卡德纳斯医院因红斑寇蛛咬伤入院的患者进行了一项回顾性研究。12名患者被诊断为蛛毒中毒。11人在从事农业劳作时被咬伤,其中8次是在温室中被咬。咬伤至出现全身症状的平均时间为40分钟(20 - 120分钟),最常见的体征和症状为:疼痛和腹部僵硬(10例)、咬伤部位红斑(10例)或疼痛(8例)、胸痛、肢体疼痛及挛缩和精神运动障碍(6例)。实验室检查结果仅限于白细胞增多(4例)、肌酸磷酸激酶计数升高(4例)和蛋白尿(3例)。所有患者均接受了止痛治疗,6例使用了肌肉松弛剂,6例给予了葡萄糖酸钙。所有患者病情转归良好,无并发症发生。在西班牙,蛛毒中毒是一种罕见现象。当缺乏明确的蜘蛛咬伤史且由于对其症状学缺乏了解时,诊断较为困难。通常不需要抗蛇毒血清。