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Red-back spider envenomation in children in Central Australia
Christopher E Trethewy1, Srinivas Bolisetty, Gavin Wheaton
1Emergency Department, Gosford Hospital, Gosford, New South Wales, Australia. chrisandsal@bigpond.com
Insights
Red-back spider (RBS) bites frequently cause systemic envenomation in Australian children. Irritability, hypertension, and sweating are key indicators of latrodectism in affected children.
Area of Science:
- Toxicology
- Pediatric Medicine
- Arachnology
Background:
- Red-back spider (RBS) envenomation is a significant concern in pediatric populations.
- Understanding the clinical presentation is crucial for timely diagnosis and management.
Purpose of the Study:
- To delineate the clinical spectrum of Red-back spider (RBS) envenomation in children up to 12 years of age.
- To identify key systemic features indicative of RBS bite in pediatric patients.
Main Methods:
- Retrospective review of pediatric case notes with a discharge diagnosis of RBS bite.
- Data collected from Alice Springs Hospital, serving Central Australia, between January 1992 and June 2001.
- Analysis of 54 pediatric patients (39 Aboriginal, 15 non-Aboriginal).
Main Results:
- A high incidence of systemic envenomation (85%) was observed in children.
- The most frequent systemic features were irritability, hypertension, and sweating, present in 65% of cases.
- Antivenom therapy was administered to 83% of the children, with no significant age-related differences in outcomes.
Conclusions:
- Systemic envenomation from Red-back spider bites is common in children in Central Australia.
- The combination of irritability, hypertension, and sweating in a previously healthy child strongly suggests latrodectism.
- Prompt recognition of these symptoms is vital for effective pediatric care following RBS bites.
Objective:
To describe the clinical spectrum of Red-back spider (RBS) envenomation in children up to 12 years of age.
Methods:
Retrospective case notes review of children with a discharge diagnosis of RBS bite from January 1992 to June 2001. The setting was Alice Springs Hospital, the main paediatric hospital for the whole region of Central Australia. The patients were 54 children, comprising 39 Aboriginal and 15 non-Aboriginal children.
Results:
Forty-six (85%) children had systemic envenomation. The three most common systemic features are irritability, hypertension and sweating; 35 (65%) children had all three systemic features. Forty-five (83%) received antivenom therapy. The clinical characteristics and outcomes showed no significant difference between children 4 and > 4 years of age.
Conclusions:
There is a high incidence of systemic envenomation due to RBS bite in children in Central Australia. The triad of irritability, hypertension and sweating in a previously well child is highly suggestive of latrodectism.