Mordedura de araña: reporte de un caso asociado a reacción de hipersensibilidad al suero antiloxocélico y aproximación al manejo general de estos accidentes

Abstract

Loxoscelism is a clinical picture produced by the bite of the Loxosceles laeta spider. In Peru in 2021 almost 400 cases have been reported so far this year. The forms of presentation are cutaneous loxoscelism, which is the most frequent form, and cutaneous-visceral loxoscelism, less frequent but more deadly. Our case is a 33-year-old patient who came to the emergency room due to erythema and edema on the back of the arm not associated with pain; he stated that he had been bitten by a spider 48 hours before admission. He is hospitalized for monitoring, administration of antiloxocelic serum and antibiotics. In the evolution in hospitalization, he develops manifestations of cutaneous Loxocelism, however, other manifestations appear, distant from the original lesion, such as rash, itching and numbness in the hands and feet, and other parts of the body progressively; A dose of antiloxocelic serum, antibiotics, corticosteroids and antihistamines were administered. An allergic reaction to the administered serum is suspected, this would be part of the early adverse reactions to antivenoms. On the other hand, the management of Loxocelism constitutes a therapeutic challenge due to the fact that there is no unanimity in its treatment, however, important considerations must be taken into account for its timely approach. It is also important to recommend preventive measures to the general population to avoid this type of accident.