%0 Journal Article
%T Clinical and epidemiological features of definitive and presumed loxoscelism in S o Paulo, Brazil
%A M¨˘LAQUE Ceila Maria Sant'Ana
%A CASTRO-VALENCIA Jaime Enrique
%A CARDOSO Jo£żo Luiz Costa
%A FRAN£żA Francisco Oscar de Siqueira
%J Revista do Instituto de Medicina Tropical de S£żo Paulo
%D 2002
%I Instituto de Medicina Tropical
%X A retrospective study analysed 359 proven or presume cases of loxoscelism seen at the Hospital Vital Brazil, Instituto Butantan, S o Paulo, Brazil, between 1985 and 1996. The spider was identified in 14%. The bites occurred predominantly in the urban areas (73%) between September and February. Patients > 14 years were commonest inflicted (92%) and 41% were bitten while getting dressed. Only 11% sought medical care within the first 12 hours post bite. Cutaneous loxoscelism was the commonest form presenting (96%); commonest manifestations were: pain (76%), erythema (72%), edema with enduration (66%), ecchymosis (39%). Skin necrosis occurred in 53% of patients, most frequently seen on trunk, tigh and upper arm, and when patients seek medical care more than 72 hours after bite. Local infection was detected in 12 patients (3%). Hemolysis was confirmed in 4 cases (1.1%). Generalised cutaneous rash, fever and headache were also observed in 48% of the total of patients. None of them had acute renal failure or died. Treatment usually involved antivenom administration (66%), being associated with corticosteroids (47%) or dapsone (30%). Presumptive diagnosis of loxoscelism may be established based on clinical and epidemiological findings. Further investigations are required to prove the value of antivenom and other treatment schedules.
%K Spider bite
%K Loxosceles
%K Dermonecrosis
%K Envenoming
%K Loxoscelism
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652002000300005