Reversible myocarditis after spider bite

Black widow spiders (Latrodectus tredecimguttatus) are poisonous spiders endemic in Turkey. Latrodectus bites may cause myocarditis with increased cardiac enzymes. We treated two men (aged 20 and 33 years) who had myocarditis after black spider bites with leucocytosis and elevated levels of troponin...

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Bibliographic Details
Published in:BMJ case reports 2013-04, Vol.2013, p.bcr2013008957
Main Authors: Kara, Hasan, Ak, Ahmet, Bayir, Aysegul, Avci, Ahmet
Format: Article
Language:English
Subjects:
Abdomen
Adult
Animals
Biomarkers - blood
Black Widow Spider
Blood pressure
Cardiac arrhythmia
Echocardiography
Electrocardiography
Enzymes
Europe (East)
Heart rate
Humans
Insect bites
Kinases
Leukocytes
Male
Myocarditis
Myocarditis - chemically induced
Myocarditis - therapy
Pain
Patients
Potassium
Rare Disease
Spider Bites - complications
Spider Bites - therapy
Spider Venoms - poisoning
Spiders
White
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Summary:Black widow spiders (Latrodectus tredecimguttatus) are poisonous spiders endemic in Turkey. Latrodectus bites may cause myocarditis with increased cardiac enzymes. We treated two men (aged 20 and 33 years) who had myocarditis after black spider bites with leucocytosis and elevated levels of troponin I, creatine kinase and creatine kinase-MB fraction. Both patients had normal results on an ECG, and one patient had abnormal echocardiography with minimal left ventricular wall movement disorder. Both patients were hospitalised in the intensive care unit and treated with intravenous fluids, analgesics, spasmolytic drugs, tetanus prophylaxis and cardiac monitoring. The levels of troponin I, creatine kinase and creatine kinase-MB fraction improved, and the patients were discharged home on the third and fifth hospital day without complications. Myocarditis after a Latrodectus bite is rare, but may be associated with serious complications. Therefore, in regions endemic with Latrodectus spiders, prudent treatment of spider bites may include cardiac evaluation and monitoring.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-008957