title: [Neurotoxic manifestations of black widow spider envenomation in paediatric patients].
abstract: BACKGROUND
  Envenomation by black widow spiders manifests clinically with signs of neurotoxicity in paediatric patients.
  
  
  OBJECTIVE
  Identify typical neurological signs and symptoms in paediatric patients of different ages, and describe treatment and outcomes in a paediatric hospital in northwest Mexico.
  
  
  METHODS
  We reviewed 70 clinical records of patients hospitalised due to black widow spider bite between 1978 and 2014. We divided the total into 2 groups: Group 1, infants and preschool children; and Group 2, school-age children and adolescents. The demographic variables were age, sex, birthplace, place where envenomation occurred, body part(s) affected, degree of envenomation according to signs and symptoms, treatment, clinical outcome, and statistical differences.
  
  
  RESULTS
  Boys accounted for 61.4% of all cases, and infants younger than one year old made up 14.2%. Most patients (70%) were bitten by the spider at home; the anatomical areas most frequently affected were the legs, neck, thorax, and abdomen. The neurological signs and symptoms displayed by Group 1 were irritability, constant crying, sialorrhoea, nausea, tachycardia, arrhythmias, fatigue when walking, agitation, muscle spasms paraesthesia, tetany, seizures, and nystagmus. Signs in Group 2 included localized pain, headache, sialorrhoea, paraesthesia, profuse sweating, anxiety, muscle weakness, muscle spasms, and fine tremor. The predominant autonomic sign in Group 1 was sialorrhoea (P<.0001) and in Group 2, paraesthesia (P<.0001). Patients who received Fab antivenom treatment displayed better outcomes and shorter hospital stays than those who did not. No deaths were reported.
  
  
  CONCLUSIONS
  The neurological signs and symptoms caused by black widow spider bite are predominantly autonomic, and identifying them permits early diagnosis and more effective treatment.
authors: Departamento de Medicina y Ciencias de la Salud, Universidad de Sonora, Hospital Infantil del Estado de Sonora, Hermosillo, Mexico. Electronic address: nsotelo51@gmail.com.
authors: N
authors: N
authors: Sotelo-Cruz
authors: Servicio de Urgencias Pediátricas, Hospital Infantil del Estado de Sonora, Hermosillo, Mexico.
authors: N
authors: N
authors: Gómez-Rivera
mesh_terms: D000293:Adolescent; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology; D001740:Black Widow Spider; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009422:Nervous System Diseases / Q000209:etiology; D020258:Neurotoxicity Syndromes / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D001098:Spider Bites / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D000997:Antivenins
keywords: Antivenenos faboterápicos; Black widow spider; Envenenamiento; Envenomation; Fab antivenom; Latrodectus mactans; Neurological signs; Signos neurológicos; «Araña viuda negra»