Systemic loxoscelism presented in a pregnant patient

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María del Carmen Sánchez-Villegas
Daniel Rodríguez-Álvarez
Concepción Ortega-Carrillo
Alejandro Alagón-Cano
Jaime Antonio Zaldívar-Cervera
Jorge Loría-Castellanos
Norma Alicia Urzúa-Rodríguez

Keywords

Spider bites, Emergencies, Pregnancy, Antivenins

Abstract

Background: loxoscelism is a condition caused by the inoculation of a series of proteolytic enzymes through the loxosceles spider bite (violinist). Morbidity and mortality is unknown in our country. The loxoscelism toxi-syndrome of local expression may have a good prognosis; however, viscera-cutaneus or systemic form has a serious and often fatal evolution. We report a case of a systemic variant developed in a pregnant patient.

Clinical case: we present the first reported case of systemic loxoscelism in a pregnant patient, highlighting the survival of the mother-son, in the presence of viscera-cutaneus behavior. We describe the natural history of clinical expression, highlighting the benefit of current therapeutic antivenom fourth generation and immunoregulation role in supporting the therapeutic approach and the guideline of the surgical approach.

Conclusions: the appropriate multidisciplinary management coupled with an early use of antivenom limits the severity and the potential development of complications. Clinical suspicion is the cornerstone of therapeutic management of these patients.

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