Relato de um caso de latrodectismo ocorrido em Manaus, Amazonas, Brasil / Report of a case of latrodectism occurring in Manaus, Amazonas, Brazil

RESUMO

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.

ABSTRACT

In July 2, 1995 arrived at the Instituto de Medicina Tropical do Amazonas as 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 occurred in the suburbs of Manaus. The patient was given neostigmine preceded by atropine, calcium gluconate, cimetidine, diazepan and hydrocortisone. Within three days the patient showed improvement, and was aware, orientated and with significant palpebral oedema 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 erythema. The patient was discharged without symptoms after the 13th 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 which has characterized the growth of the city of Manaus, in the last twenty years. It is not possible at this point to evaluate the epidemiological resound of the event, but in any case, it seems plausible to recommend that black widow antivenom become available.