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A black widow spider bite in a child caused severe symptoms, but she recovered fully with only intravenous fluids. This case suggests conservative treatment may suffice, though antiserum is vital for severe cases.
Area of Science:
- Toxicology
- Pediatric Medicine
- Envenomation Management
Background:
- Black widow spider (Latrodectus) envenomation can cause significant systemic effects.
- Pediatric patients may present with unique symptom profiles and require tailored management.
- Understanding the spectrum of clinical presentations is crucial for effective treatment.
Observation:
- A 4-year-old girl presented 30 hours post-black widow spider bite with restlessness, diaphoresis, abdominal pain, and fever.
- Hypertension, hematuria, and electrocardiogram (ECG) abnormalities developed subsequently.
- The child received only intravenous fluid resuscitation.
Findings:
- The patient experienced a complete recovery and was discharged within a week.
- Pharmacological interventions, including muscle relaxants and calcium gluconate, were deemed unnecessary in this specific case.
- Literature review indicates muscle relaxants and calcium gluconate are common treatments, with antiserum reserved for severe cases or pregnancy.
Implications:
- Conservative management with intravenous fluids alone can be effective in select pediatric black widow spider bite cases.
- Prompt recognition of symptoms and supportive care are paramount.
- Black widow antiserum remains a critical intervention for severe envenomations and in pregnant patients, given the potential for serious complications and a 5-10% mortality rate.
Abstract:
A 4-year-old girl was admitted 30 hours after being bitten by a black widow spider. The presenting symptoms were restlessness, profuse perspiration, severe abdominal pain and fever, while hypertension, hematuria and ECG changes developed later. Treatment was with intravenous fluids only, and she recovered completely and was discharged after a week. According to the literature, management includes muscle relaxants, such as methocarbamal and diazepam, and intravenous calcium gluconate is recommended by some. We found pharmacological intervention unnecessary in this case, but in severe cases and in pregnancy black widow antiserum is indicated. The overall mortality rate 5-10%.