Caso sospechoso de envenenamiento por araña reclusa (loxosceles) y revisión de la literatura

El Loxoscelismo en una enfermedad causada por la picadura de una araña del género Loxosceles, que se puede manifestar con compromiso cutáneo y/o sistémico e incluso llevar a la muerte. La distribución geográfica de la araña es mundial, con mayor incidencia en países como Perú, Chile y Brasil, y en algunos lugares de Norte América. En Colombia, se ha identificado este tipo de arácnido, sin embargo no se ha reportado ningún caso, se cree que probablemente exista subregistro. El cuadro clínico puede ir desde pacientes asintomáticos hasta dermonecrosis severa, con gran riesgo de secuelas e incapacidad funcional. Cuando hay compromiso sistémico, cursa con falla renal, hemólisis, coagulación intravascular diseminada y alto riesgo de muerte. El diagnóstico es clínico y epidemiológico, pues no hay pruebas serológicas confirmatorias disponibles. A pesar de que se han descrito múltiples opciones terapéuticas, no hay un consenso que permita hacer recomendaciones, por la escasa evidencia científica que existe al respecto. Este artículo presenta el caso de un varón de 11 años, con antecedente de picadura por animal desconocido, con evolución clínica sugestiva de loxoscelismo cutáneo y sistémico, que recibió manejo con suero antiarácnido, oxígeno hiperbárico, inhibidor de polimorfonucleares y reconstrucción quirúrgica. Se revisa la literatura y la situación de la enfermedad en Colombia, con el fin de llamar la atención sobre una enfermedad poco conocida y favorecer la sospecha diagnóstica y el enfoque adecuado.

Brown Recluse Spider Venom: Proteomic Analysis and Proposal of a Putative Mechanism of Action

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The brown recluse spider and other spiders associated with buildings.

"5/03"--Colophon.

Loxosceles chapadensis (Araneae: Sicariidae): a new recluse spider species of the gaucho group from Brazil

A new species of the medically important recluse spider genus Loxosceles Heinecken & Lowe 1832 is described from the State of Bahia, Brazil. The species occurs between rocks and crevices, as well as in and around man-made structures. The new species belongs to the gaucho group, as evidenced by the spermathecal shape and color pattern. The presence of a long male palpal tibia is unusual in the gaucho group; thus, the inclusion of the new species in this group is discussed.

Brown recluse and black widow spiders.

"09/07"--Colophon.

Effect of architectural angularity on refugia selection by the brown spider, Loxosceles gaucho

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Swiss prospective study on spider bites

Knowledge of spider bites in Central Europe derives mainly from anecdotal case presentations; therefore we aimed to collect cases systematically. From June 2011 to November 2012 we prospectively collected 17 cases of alleged spider bites, and together with two spontaneous notifications later on, our database totaled 19 cases. Among them, eight cases could be verified. The causative species were: Cheiracanthium punctorium (3), Zoropsis spinimana (2), Amaurobius ferox, Tegenaria atrica and Malthonica ferruginea (1 each). Clinical presentation was generally mild, with the exception of Cheiracanthium punctorium, and patients recovered fully without sequelae. In Switzerland, spider bites generally have a benign clinical course, which is characterised by minor effects, with rapid and complete recovery. Since only verified spider bites can be regarded as spider bites, in the case of clinically important arachnidism, the spider should be sent to an expert for identification. Our study may help to diminish spider fear and reassure people who have experienced a bite. The study was registered at ClinicalTrials.gov (NCT01355744).

A two year study of verified spider bites in Switzerland and a review of the European spider bite literature

During a two-year study, all spider bites recorded by Swiss primary care physicians were reported to the Swiss Toxicological Information Centre and all collected spiders were identified. A total of 14 verified spider bites were recorded, involving five species from four families: Zoropsis spinimana (five cases), Cheiracanthium punctorium (four cases), Tegenaria atrica (three cases) and one case of Malthonica ferruginea (¼ Tegenaria ferruginea) (both Agelenidae), and one case of Amaurobius ferox (Amaurobiidae). The bites of all spider species produced relatively mild symptoms. Local symptoms such as moderate to severe pain, circumscribed swelling and redness were the only effects in most cases. Systemic symptoms were rare. There was complete recovery in all cases and all lesions healed completely without further damage or secondary disorders. Following a review of the European spider bite literature, the number of spider species capable of biting humans in Europe is considered to be much larger than could be concluded from this study. Most spider bites are restricted to species living synanthropically, thus promoted by climate and habitat change. The annual frequency of spider bites in Switzerland is estimated at 10 – 100 bites per million inhabitants, but this is predicted to increase due to the continuous arrival of new alien species, many of which have a high potential to establish in urban areas

Recent advances in the understanding of brown spider venoms: From the biology of spiders to the molecular mechanisms of toxins

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Sistematização da Assistência de Enfermagem: acidente por Loxosceles gaucho.

Experience report carried out at a university hospital involving a patient victimized by an accident with a spider of the Loxosceles gaucho genus. This type of accident can be classified as mild, moderate and severe, depending on the period of time elapsed between the occurrence of the accident and the moment of care provision. We aimed at applying nursing care systematization in a comprehensive and humanized manner. The following nursing diagnoses were established: acute pain, damaged skin integrity, risks for infection, constipation and low self-esteem. The therapeutic relationship favored student/patient interactions and enabled the recognition of the needs that deserved nursing interventions. The nursing process was a valuable instrument and provided important elements for the patient's daily development and planning adjustment by prioritizing care quality.

Idiopathic necrotizing dermatitis: Current management

Objectives: To identify and demonstrate necrotizing dermatitis in infancy; an uncommon, puzzling syndrome, in which anecdotal reporting and personal experience indicates that one third of cases may require skin grafting. Much informed discussion about the pathogenesis of this distressing syndrome centres on the role of spider envenomation; and in particular on the speculative role of the Australian White-tailed spider, Lampona cylindrata. Methods: We present here six cases of necrotizing dermatitis treated surgically at the Royal Children's Hospital and Mater Children's Hospital in Brisbane over the period from 1991 to 1999. Clinical history, surgical details and pathological investigations were reviewed in each case. Microbiological investigation of necrotic ulcers included standard aerobic and anaerobic culture. Result: Nocardia and Staphylococcus were cultured in two cases, but no positive bites were witnessed and no spiders were identified by either the children or their parents. All cases were treated with silver sulphadiazine creme. Two of the infants required general anaesthesia, excision debridement and split skin grafting. The White-tailed spider, Lampona cylindrata, does not occur in Queensland, but Lampona murina does; neither species has necrotizing components in its venom. Circumstantial evidence is consistent with this syndrome being due to invertebrate envenomation, possibly following arachnid bites. Conclusion: In our experience there is insufficient evidence to impute a specific genus as the cause, at this stage of scientific knowledge. If the offending creature is a spider, we calculate that the syndrome of necrotizing dermatitis occurs in less than 1 in 5000 spider bites.

Necrotic skin lesion in a dog attributed to Loxosceles (brown spider) bite: a case report

Envenomations caused by Loxosceles (brown spider) have been reported throughout the world. Clinical signs associated to bites of these spiders involve dermonecrotic lesions and intense local inflammatory response, besides systemic manifestations such as intravascular hemolysis, thrombocytopenia, disseminated intravascular coagulation and acute renal failure. The present study aimed to report and to describe dermonecrotic lesions probably caused by a Loxosceles envenomation in a four year-old poodle female dog, treated at the Dermatology Service of the Veterinary Hospital of the Veterinary Medicine and Animal Husbandry School, São Paulo State University, Botucatu, Brazil. Initially, the animal presented two skin lesions with blackish aspect that evolved into ulcerative crusts. The owner reported the presence of a brown spider near the place where the animal spent most of the time. Histological examination of lesions revealed necrosis of the epidermis extending to adnexa and panniculi, which is compatible with Loxosceles bite reaction. The animal was treated with systemic antibiotic and local curatives. Lesions healed by second intention in two months.

On the development of the brown spider Loxosceles gaucho Gertsch (Araneae, Sicariidae): the nympho-imaginal period

Observations of the developmental biology of Loxosceles gaucho Gertsch, 1967, the brown spider of southeastern Brazil are scarce. The present study reports the method of individualized rearing of 18 populations of L. gaucho, kept in laboratory under varied diet conditions, and characterizes their nympho-imaginal period as well as factors related to their reproduction. Females built the first egg sac about 20 days after copulation and nymphs hatched 40 days after the laying date. Average offspring was 61.3 spiderlings and females usually built three to four successive egg sacs in a period of five to seven months. First nymphs initiated their predatory activity between the 5th and 8th days after hatching and the majority reached adulthood within six moults (range of five to eight) in approximately 15 to 17 months (male) and 15.5 to 18 months (female). The average sex ratio equaled 1.0:1.7 (male:female). The wide individual variability of this species intermoult intervals is herewith expressed by the intermoult rate, which was fairly uniform for both intra and interpopulations and gives a relevant aspect for a general idea of the life cycles of spiders.

Structural insights into substrate binding of brown spider venom class II phospholipases D

Phospholipases D (PLDs), the major dermonecrotic factors from brown spider venoms, trigger a range of biological reactions both in vitro and in vivo. Despite their clinical relevance in loxoscelism, structural data is restricted to the apo-form of these enzymes, which has been instrumental in understanding the functional differences between the class I and II spider PLDs. The crystal structures of the native class II PLD from Loxosceles intermedia complexed with myo-inositol 1-phosphate and the inactive mutant H12A complexed with fatty acids indicate the existence of a strong ligand-dependent conformation change of the highly conserved aromatic residues, Tyr 223 and Trp225 indicating their roles in substrate binding. These results provided insights into the structural determinants for substrate recognition and binding by class II PLDs.

Crystallization and preliminary crystallographic analysis of SMase I, a sphingomyelinase from Loxosceles laeta spider venom

SMase I, a 32 kDa sphingomyelinase found in Loxosceles laeta venom, is responsible for the major pathological effects of spider envenomation. This toxin has been cloned and functionally expressed as a fusion protein containing a 6 x His tag at its N-terminus to yield a 33 kDa protein [Fernandes-Pedrosa et al. (2002), Biochem. Biophys. Res. Commun. 298, 638 - 645]. The recombinant protein possesses all the biological properties ascribed to the whole L. laeta venom, including dermonecrotic and complement-dependent haemolytic activities. Dynamic light-scattering experiments conducted at 291 K demonstrate that the sample possesses a monomodal distribution, with a hydrodynamic radius of 3.57 nm. L. laeta SMase I was crystallized by the hanging-drop vapour-diffusion technique using the sparse-matrix method. Single crystals were obtained using a buffer solution consisting of 0.08 M HEPES and 0.9 M trisodium citrate, which was titrated to pH 7.5 using 0.25 M sodium hydroxide. Complete three-dimensional diffraction data were collected to 1.8 Angstrom at the Laboratorio Nacional de Luz Sincrotron (LNLS, Campinas, Brazil). The crystals belong to the hexagonal system ( space group P6(1) or P6(5)), with unit-cell parameters a = b = 140.6, c = 113.6 Angstrom. A search for heavy-atom derivatives has been initiated and elucidation of the crystal structure is currently in progress.