背景:塔兰图拉病毒很少遇到,但随着外来动物所有权的增加,病毒可能会增加。该病例报告介绍了委内瑞拉太阳虎狼anter(VST)的首次记录毒性,女神女神,并提供了一个一般的框架,以接近与狼蜘蛛暴露的患者。
方法:一名35岁的男子在被宠物VST咬伤4小时后被送往急诊科。他出现了红斑,疼痛,和向近侧延伸的左鱼际隆起的咬伤部位水肿。在4小时内,他出现了腹痛,恶心,呕吐,喉咙瘙痒,和紧绷。病人的血压为131/105mmHg,心率102次/分钟,36.6°C,20次呼吸/分钟的呼吸频率,和94%的SpO2。实验室评估在正常范围内(除了长期升高但转氨酶有所改善)。患者肌内接受0.5mg肾上腺素,50毫克苯海拉明IV,20毫克法莫替丁IV,0.4mg昂丹司琼IV,和1升生理盐水用于疑似过敏反应。肾上腺素给药后不久,他的胃肠道和上呼吸道症状得到了缓解。所有症状在1周内缓解。为什么紧急物理学家应该意识到这一点?:对VST毒性知之甚少。因此,提供者应该依靠一个一般框架来接触狼兰暴露的患者.从狼兽暴露的发病率是由机械损伤介导,毒液效应,和超敏反应。典型的临床表现包括局部疼痛,瘙痒,水肿,红斑,和燃烧。肌肉抽筋,结节性眼炎,和超敏反应可能发生。治疗主要是支持性的,包括去污,凉爽的压缩,镇痛,过敏反应的治疗,和眼科评估,如果眼睛暴露。
Tarantula envenomations are encountered infrequently but may increase with increased exotic animal ownership. This case report presents the first documented toxicity from a Venezuelan suntiger
tarantula (VST), Psalmopoeus irminia, and provides a general framework for approaching patients with
tarantula exposures.
A 35-year-old man presented to an emergency department 4 h after experiencing a bite from his pet VST. He developed erythema, pain, and edema to the bite site on the left thenar eminence that extended proximally. Within 4 h, he developed abdominal pain, nausea, vomiting, throat itching, and tightness. The patient had a blood pressure of 131/105 mm Hg, heart rate of 102 beats/min, 36.6°C, respiratory rate of 20 breaths/min, and SpO2 of 94%. Laboratory evaluations were within normal limits (other than chronically elevated but improved transaminases). The patient received 0.5 mg epinephrine intramuscularly, 50 mg diphenhydramine IV, 20 mg famotidine IV, 0.4 mg ondansetron IV, and 1 L of normal saline for a suspected anaphylactic reaction. Shortly after epinephrine administration, his gastrointestinal and upper airway symptoms resolved. All symptoms resolved within 1 week. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Little is known about VST toxicity. Therefore, providers should rely on a general framework for approaching patients with
tarantula exposures. Morbidity from
tarantula exposures is mediated by mechanical injury, venom effects, and hypersensitivity reactions. Typical clinical findings include local pain, pruritis, edema, erythema, and burning. Muscle cramping, ophthalmia nodosa, and hypersensitivity reactions may occur. Treatment is primarily supportive and includes decontamination, cool compresses, analgesia, treatment of anaphylaxis, and ophthalmology evaluation if ocular exposure.