Black widow poisoning is rare, but the effects of its highly neurotoxic venom.
The case was reported in Puerto Rico. Photos: Provided by Dr. Marely Santiago, dermatologist to the Journal of Medicine and Public Health.
The black widow spider, Latrodectus spp, is one of the most clinically important spiders in the world and is not usually endemic to the Caribbean. Poisoning by this animal is rare, but the effects of its venom are highly neurotoxic, ranging from localized skin irritation and pain to more systemic symptoms.
Precisely, a clinical case registered in Puerto Rico describes the consequences of a black widow spider bite in Puerto Rico and calls for conscience to health professionals, so that they consider the rare diagnosis of this type of scenario.
This was a 52-year-old man who presented to the emergency room due to a erythematous swelling Acute pain in the left upper extremity, with associated diaphoresis, chills, and ipsilateral periorbital edema after he identified a black widow spider near his bed.
Los dermatologistsattached to the Medical Sciences Campus, showed him a “photo lineup” of more than six different species of spiders, and he identified the black widow spider as the specimen found.
During his physical examination, the patient presented multiple tense bullae on a violaceous background with left thenar eminence and thumb and visible fang marks.
Likewise, he presented facial edema, swelling, pain and limited range of motion from the left hand to the middle of the forearm, detailed the authors of the case, among whom were doctors Francisco Colón, Osward Carrasquillo, Natalia Pelet and Dr. Marely. Santiago, everyone dermatologists.
The patient presented elevated blood pressure, neutrophilia, creatine phosphokinase (CPK), and transaminitis.
Doctors explain that black widow spider bite diagnoses are usually clinical, but certain laboratory findings can help characterize its envenomation. Local wound care and supportive care may be chosen for uncomplicated cases.
Dr. Marely Santiago, dermatologist and one of the authors of the case. Photo provided by the specialist to the Journal of Medicine and Public Health.
The potent animal venom, alpha-latrotoxin, induces exocytosis of adrenergic and cholinergic neurotransmitters responsible for this clinical syndrome and laboratory findings, such as elevated CPK.
They argue that this type of non-endemic animal could be in an uncommon region due to human transport.
Our case highlights the importance of physicians considering black widow spider bites as a differential diagnosis in the appropriate clinical setting, the physicians conclude.
Access the case here.