Relato de um caso de latrodectismo ocorrido em Manaus, Amazonas, Brasil

• Published in: Revista da Sociedade Brasileira de Medicina Tropical 1998-02, Vol.31 (1), p.95-98
• Main Authors: Souza, Alcidéa R. B. de, Bührnheim, Paulo F., Lima, Cinira S. C.
• Format: Article
• Language: English
• ISSN: 0037-8682; 0037-8682
• DOI: 10.1590/S0037-86821998000100012

Em 02/07/1995, foi atendido no Instituto de Medicina Tropical do Amazonas, paciente masculino, 11 anos, acidentado em Manaus, por picada na região retroauricular direita, clínicamente compatível com aquele causado por Latrodectus. Observavam-se abalos musculares, febre, calafrios e sudorese intensa. Instituída terapêutica com neostigmine precedido de atropina, gluconato de cálcio, cimetidina, diazepam e hidrocortisona. No terceiro dia apresentava-se melhorado, consciente, orientado e com diminuição importante do edema palpebral. A despeito de uma melhora progressiva diária, no quinto dia surgiu eritema máculo-pápulo-vesiculoso. Em 14/07/1995 teve alta, assintomático. O caso relatado é o primeiro descrito na região Amazônica, ocorrido na periferia de Manaus e pode ter sido uma consequência da expansão urbana das duas últimas décadas. In July 2, 1995 arrived at the Instituto de Medicina Tropical do Amazonas an eleven-year-old male with complaining of spider bite on his right retroauricular region, presenting typical findings of latrodectism. The accident was reported as having ocurred in the suburbs of Manaus. The patient was given neostigmine preceded by atropin, calcium gluconate, cimetidin, diazepan and hidrocortisone. Within three days the patient showed improvement, and was aware, orientated and with significant palpebral oedem reduction. Muscle spasms are still present, as well as fever, shivering, and intense sweating. In spite of a daily progressive improvement, at the fifth day appeared a spotted papular erythem. The patient was discharged without simptoms after the13th day. This is the first such reported case which took place in Amazonian region, it might have been happened a consequence of the urban sprawl wich has characterized the growth of the city of Manaus, in the last twenty years. It is not possible at this point to evaluate the epidemiolgical resounds of the event, but in any case, it seems plausible to recommend that black widow antivenom become avaiable.