Loxoscelismo y latrodectismo en una paciente: caso clínico / Loxoscelism and latrodectism in the same patient

RESUMO

We report a 51 years old, woman, who live in a rural zone of Llolleo, San Antonio, V Región of Chile. Her dewelling is near a wheat ground sown. In november 1999 during the cleaning of her house she felt a "bug" in her head, but did not find it. She started immediatly with itching, hypoesthesia of arms and legs, dispnea, thoracic pain, vomiting, 40§C fever, myalgias in right arm, thorax, and hypogastric zone, trembling, plantiful sweating, and rapidly lost consciousness. She recovered consciousness 1 hour later and asked for help. A neighbour saw and captured a spider going out of her clothes. She was taken to the emergency room, where she received sera and oxigen, and was discharged two days later with a prescription of antihistaminics, glucosteroids, a muscle relaxing agend and diuretics. During six months se was controled in the out patient clinic of the hospital. The spider was identified by entomologist as Latrodectus mactans. In june 2002 when she was sleeping, felt a wounding lancet pain in the middle finger of the right hand. Afterwards a black plate with yellow vesicles in his center appeared in that same zone. The right arm become edematous and paresthetic; the patient complained of an important asthenia. She was hospitalized receiving intravenous steroids. In this ocassion the patients couldnït keep the spider, but when she describes it to the entomologist of the National Science and Arqueological Museum of San Antonio, the specimen was identified as an exemplar of Loxosceles laeta . Latrodectism is usually a day out door accident, during agricultural activities. Loxoscelism is in general a night in door accident. In this excepcional case the patient lives near a wheat ground sown and the absence of routinary cleaning of her dewelling, could explain both accidents. We couldïnt find publications of accidents of both spiders affecting the same person. For this reason we consider important to comunicate this case