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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
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.