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Copyright of Revista de Educación e Investigación en Emergencias is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Poisoning by widow-spider (genus Latrodectus) bites occurs worldwide. The illness, termed latrodectism, can cause severe and persistent pain and can lead to muscle rigidity, respiratory complications, and cardiac problems. It is a global health challenge especially in developing countries. Equine serum-derived polyclonal anti-sera are commercially available as a medication for patients with latrodectism, but the use of sera imposes potential inherent risks related to its animal origin. The treatment may cause allergic reactions in humans (serum sickness), including anaphylactic shock. Furthermore, equine-derived antivenom is observed to have batch-to-batch variability and poor specificity, as it is always an undefined mix of antibodies. Because latrodectism can be extremely painful but is rarely fatal, the use of antivenom is controversial and only a small fraction of patients is treated. In this work, recombinant human antibodies were selected against alpha-latrotoxin of the European black widow (Latrodectus tredecimguttatus) by phage display from a naïve antibody gene library. AlphaLatrotoxin (α-LTX) binding scFv were recloned and produced as fully human IgG. A novel alamarBlue assay for venom neutralization was developed and used to select neutralizing IgGs. The human antibodies showed in vitro neutralization efficacy both as single antibodies and antibody combinations. This was also confirmed by electrophysiological measurements of neuronal activity in cell culture. The best neutralizing antibodies showed nanomolar affinities. Antibody MRU44–4-A1 showed outstanding neutralization efficacy and affinity to L. tredecimguttatus α-LTX. Interestingly, only two of the neutralizing antibodies showed cross-neutralization of the venom of the Southern black widow (Latrodectus mactans). This was unexpected, because in the current literature the alpha-latrotoxins are described as highly conserved. The here-engineered antibodies are candidates for future development as potential therapeutics and diagnostic tools, as they for the first time would provide unlimited supply of a chemically completely defined drug of constant quality and efficacy, which is also made without the use of animals. [ABSTRACT FROM AUTHOR]

Poisoning by widow-spider (genus Latrodectus) bites occurs worldwide. The illness, termed latrodectism, can cause severe and persistent pain and can lead to muscle rigidity, respiratory complications, and cardiac problems. It is a global health challenge especially in developing countries. Equine serum-derived polyclonal anti-sera are commercially available as a medication for patients with latrodectism, but the use of sera imposes potential inherent risks related to its animal origin. The treatment may cause allergic reactions in humans (serum sickness), including anaphylactic shock. Furthermore, equine-derived antivenom is observed to have batch-to-batch variability and poor specificity, as it is always an undefined mix of antibodies. Because latrodectism can be extremely painful but is rarely fatal, the use of antivenom is controversial and only a small fraction of patients is treated. In this work, recombinant human antibodies were selected against alpha-latrotoxin of the European black widow (Latrodectus tredecimguttatus) by phage display from a naïve antibody gene library. Alpha-Latrotoxin (α-LTX) binding scFv were recloned and produced as fully human IgG. A novel alamarBlue assay for venom neutralization was developed and used to select neutralizing IgGs. The human antibodies showed in vitro neutralization efficacy both as single antibodies and antibody combinations. This was also confirmed by electrophysiological measurements of neuronal activity in cell culture. The best neutralizing antibodies showed nanomolar affinities. Antibody MRU44–4-A1 showed outstanding neutralization efficacy and affinity to L. tredecimguttatus α-LTX. Interestingly, only two of the neutralizing antibodies showed cross-neutralization of the venom of the Southern black widow (Latrodectus mactans). This was unexpected, because in the current literature the alpha-latrotoxins are described as highly conserved. The here-engineered antibodies are candidates for future development as potential therapeutics and diagnostic tools, as they for the first time would provide unlimited supply of a chemically completely defined drug of constant quality and efficacy, which is also made without the use of animals.

Objectives: Redback spider (RBS) antivenom (RBSAV) use appears to have decreased since the results of the RAVE‐2 antivenom efficacy study were released. The aims of this study were to assess change in RBSAV use over time and compare responses to treatment for antivenom and other analgesics. Methods: Retrospective audit of RBS bite referrals to a toxicology unit, from January 2010 to January 2022. Data included demographics, pain severity, treatment (analgesia or RBSAV), response to treatment, re‐presentation rate, adverse events, change in antivenom use over time. Results: Of 270 presentations, 157 with moderate or severe pain were included (RBSAV n = 51, analgesia n = 106). Median age was 39 years, n = 81 (51%) female. Those receiving antivenom were more likely to report severe pain n = 46/51 (84%) versus n = 68/106 (58%) (P = 0.006). Eighty‐three percent of antivenom doses were administered between 2010 and 2013. Analgesia‐only group received various combinations of paracetamol, NSAIDs, and opioids. In those receiving RBSAV, 17/48 (35%), 26/48 (54%), 5/48 (10%) reported a partial, complete or no reduction in pain, respectively, versus 30/77 (39%), 43/77 (58%) and 4/77 (5%), for analgesia‐only group. Post‐treatment pain was not recorded in three RBSAV and 28 analgesia‐only patients. Pain reduction was no different for intravenous and intramuscular antivenom. Re‐presentation for ongoing pain was more common in the analgesia‐only group, 16/106 (15%) versus 1/51 (2%) for antivenom (P = 0.013). Conclusion: Antivenom use fell over the study period. There was no difference in pain relief between RBSAV and analgesia‐only groups. RBSAV, regardless of route of administration, was no better than standard analgesics in pain reduction in the present study. [ABSTRACT FROM AUTHOR]

Spiders are often wrongly designated as responsible for cutaneous eruptions. We aim to describe spider bites and the spider species implicated in metropolitan France. A retrospective observational study was conducted for all reported cases of spider bites from 2007 to 2018 extracted from the French Poison Control Centers (PCCs) information system, after exclusion of non‐native spiders. We described identification of the spider, level of certainty of the bite, symptoms and severity of cases. 1194 cases of spider bites met the inclusion criteria. The average age of the patients was 36.9 ± 19.8 years. Identification of the species or at least that a spider was implicated was only possible in 346 cases (29.0%). Loxosceles were involved in 53 cases (4.4%), Latrodectus in 46 cases (3.9%) and Cheiracanthium in 35 cases (2.9%). In one third of cases, the involved spider was not known to be present where the bite occurred. Where most of the patients (n = 1111, 93%) reported at least one cutaneous symptom, most of the symptoms were neurological. The bite was considered proven in only 242 cases (20%). Despite the efforts of arachnologists to educate the public, the fear of spiders is still alive in France, where spider bite is rare with low severity and often unproven. [ABSTRACT FROM AUTHOR]

En dehors des piqûres d'hyménoptères apidés et vespidés, des piqûres ou morsures de nombreux autres arthropodes peuvent donner lieu à des réactions cliniques, de mécanisme allergique ou toxique. Des anaphylaxies ont été décrites avec d'autres hyménoptères comme les fourmis (par exemple la « fourmi de feu » Solenopsis invicta), avec des diptères comme les moustiques et les taons, des hétéroptères comme certaines punaises (« kissing bug », « bed bug »). Parmi les arachnides, des anaphylaxies sont décrites avec certaines espèces de tiques (Ixodes ricinus , Argas reflexus). Un nombre très limité d'espèces d'aranéides (araignées) peut être à l'origine de réactions d'envenimation potentiellement sévères. Le nombre d'espèces dangereuses parmi les scorpions est plus important, mais concerne plutôt l'aspect envenimation que l'aspect immunoallergique de ces réactions. Le traitement des réactions d'envenimation est complexe et l'adrénaline n'y est pas au premier plan. D'autres insectes (simulies, culicoïdes), voire des larves d'insectes (chenilles de lépidoptères), peuvent entraîner des réactions inflammatoires et allergiques, en général peu sévères, utiles à connaître en tant que diagnostic différentiel. Les acariens arboricoles peuvent aussi être à l'origine de manifestations respiratoires proches de celles rencontrées avec les acariens domestiques. Apart from apidae and vespidae hymenoptera stings, many other arthropods can cause clinical reactions, due to allergic or toxic mechanisms. Anaphylactic reactions have been described after stings from other hymenoptera such as ants (for example « imported fire ant ») or bites from diptera (such as mosquitoes or horseflies), heteroptera such as some bugs ("kissing bug", "bed bug"). Among arachnids, anaphylactic reactions have been described after tick bites (Ixodes ricinus , Argas reflexus). A very limited number of spider species can cause potentially serious toxic reactions, which are more frequent among scorpions, rather by envenomation than by immunologic reactions. Treatment of venom toxic reactions is complex and adrenalin does not play the major role. Other insect bites (simuliidae, culicoïdes), even insect larvae (lepidoptera caterpillars) can cause inflammatory and allergic reactions, not very serious usually, but important for differential diagnosis. Spider mites can also be source of respiratory diseases similar to the house dust mites-related diseases. [ABSTRACT FROM AUTHOR]

Abstract Spiders are able to arouse strong emotional reactions in humans. While spider bites are statistically rare events, our perception is skewed towards the potential harm spiders can cause to humans. Nevertheless, there is still limited understanding of the role of the media in spreading (mis)information about them thereby promoting this distorted perception of risk. We examined the human dimension of spiders through the lens of traditional media, by analysing spider‐related news published online in Italian newspapers between 2010 and 2020 (n = 314). We assessed the accuracy, circulation and sensationalistic content of each article, and assessed how each of these features drove news' share on social media. We observed a recent, exponential increase in the frequency of the news, particularly those focused on medically important spiders—the Mediterranean black widow Latrodectus tredecimguttatus and the Mediterranean recluse Loxosceles rufescens. The news quality was generally poor: 70% contained different types of error, 32% were sensationalistic, and in virtually none was an expert consulted. The risk scenario depicted by the media reports was unnecessarily alarmist, especially with regard to L. rufescens. A conservative estimate would suggest that less than 10% of the bites reported in the media reports analysed here were delivered by the species described in the report. Moreover, two out of three casualties associated with a bite of the Mediterranean recluse were fake news, while the third was unverifiable. Overstated news referring to spider bites was shared significantly more on social media, thus contributing to frame a distorted perception of the risk. This is important given that these negative sentiments may ultimately lead to lowering public tolerance towards spiders and reducing conservation efforts towards them. We discuss open questions and avenues for future research concerning the media coverage of widely feared animals, that will help bridge knowledge gaps regarding the role of traditional and social media in framing our perception of the natural world. A free Plain Language Summary can be found within the Supporting Information of this article.

Background: Black widow spiders are distributed worldwide and, although rarely fatal, account for significant morbidity. Diagnosis can be challenging, and children are at risk of increased morbidity due to their small size.Case Report: We present a case of a 3-year-old boy who was brought to our emergency department because of sudden ear pain followed by labored breathing, abdominal pain, refusal or inability to speak, and grunting respirations. A black widow spider bite was suspected based on additional history obtained, and the spider was found in his helmet, confirming the diagnosis. The patient had progressive respiratory distress and somnolence and was intubated and transferred to a local pediatric intensive care unit. Antivenom was not initially available and eventually declined by the family. The child received supportive care and recovered after several days. Why Should an Emergency Physician Be Aware of This? This case illustrates the potentially deadly effects a black widow envenomation could cause in a child, and that bite location can affect the constellation of symptoms. It is a reminder that toxins, including that of the black widow spider, should be on the differential for acute abdominal pain, especially with autonomic features. [ABSTRACT FROM AUTHOR]

Envenomation by terrestrial toxic animals is considered a serious risk to human health worldwide. Snakes, hymenopterans, spiders, and scorpions have mainly attracted the attention of medical literature. However, the relative importance of spiders has been studied only in a few countries. Here, we present the first retrospective study on the incidence of spider bites requiring hospital care in Spain, compared to bites or stings from snakes, hymenopterans, and scorpions. Using ICD9MC and ICD10 databases from the World Health Organization's International Classification of Diseases for the period 1997-2020, we quantified the cases of envenomation by spiders, compared to those by other terrestrial toxic animals, the demographic data of envenomation cases, the relative severity of spider bites, and the geographic distribution of envenomation cases. Overall, the incidence of acute intoxication by terrestrial toxic animals in Spain was ca. 1.23 cases per million inhabitants. In decreasing order of importance, cases were due to snakes, hymenopterans, spiders, scorpions, and myriapods. Fatal cases were extremely rare, caused mainly by hymenopterans. No fatalities were caused by spiders, scorpions, and myriapods. A greater incidence of snake bites occurred in northern Spain, but no geographical trends were found for spider bites or scorpion stings. Severe poisoning or life-threatening cases due to bites or stings from toxic terrestrial animals in Spain seems to be very low, especially for spiders, compared to other countries in the world. In general, spiders do not present a risk to human health and should not be considered a major driver of morbidity., (© The Author(s) 2024. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Abstract Humankind has always been fascinated by venomous animals, as their toxic substances have transformed them into symbols of power and mystery. Over the centuries, researchers have been trying to understand animal venoms, unveiling intricate mixtures of molecules and their biological effects. Among venomous animals, Latrodectus Walckenaer, 1805 (widow spiders) have become feared in many cultures worldwide due to their extremely neurotoxic venom. The Latrodectus genus encompasses 32 species broadly spread around the globe, 14 of which occur in the Americas. Despite the high number of species found in the New World, the knowledge on these spiders is still scarce. This review covers the general knowledge on Latrodectus spp. from the Americas. We address widow spiders’ taxonomy; geographical distribution and epidemiology; symptoms and treatments of envenomation (latrodectism); venom collection, experimental studies, proteome and transcriptome; and biotechnological studies on these Latrodectus spp. Moreover, we discuss the main challenges and limitations faced by researchers when trying to comprehend this neglected group of medically important spiders. We expect this review to help overcome the lack of information regarding widow spiders in the New World.

Copyright of People & Nature is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Latrodectism is a rare, but potentially severe, clinical syndrome caused by spider of the genus Latrodectus. L. tredecimguttatus is widespread in Italy and its bite cause the injection of α-latrotoxin that cause depletion of acetylcholine at motor nerve endings and release of catecholamines at adrenergic nerve endings. We describe the first clinical case of L. tredecimguttatus poisoning successfully treated with L. mactans antivenom from North America. A healthy 60-year-old patient was admitted to the emergency department after unknown insect sting or arachnid/snake bite. In the early morning, the patient was working in the countryside when he felt a sting-like pain in the medial area of the right lower leg, associated with an intense burning sensation. An hour later he developed agitation, hoarseness, sweating, abdominal distress and intense pain in his right leg. In the emergency room vital signs showed a hypertensive crisis, tachycardia and peripheral oxygen desaturation. ECG was normal and ABE showed mixed acid-base disorder. Blood tests showed leukocytosis with neutrophilia, high levels of myoglobin, with normal coagulation and normal plasmatic cholinesterase. Neck, thorax and abdomen CT scan, with and without contrast medium, was negative. Four hours after admission hypertension worsened with board like rigid abdomen and onset of fasciculations, tremors, miosis and intense regional sweating. The definitive diagnosis of poisoning by L tredecimguttatus was based on the clinical picture. Within short time the antidote was provided by the Poison Centre and administered. A marked improvement of the symptomatology was noted after 30 minutes, and 1 hour later all symptoms were under control. The patient was discharged after 2 days. The clinical presentation of a patient suffering from latrodectism places the clinician in front of a challenging differential diagnosis. Following the suspicion, the first-line doctor is invited to discuss the case with a toxicologist, in order to confirm or exclude the diagnosis and implement all therapeutic measures. In our clinical case, the absence of organic lesions, laboratory tests not suggestive for other causes, and the presence of typical clinical feature suggested the diagnosis of L tredecimguttatus poisoning. This hypothesis was then supported by the close temporal relation between antivenom administration and symptoms improvement. With this case, we report the first use of L mactans antivenom from North America to treat L. tredecimguttatus poisoning and we confirm its effectiveness in counteracting latrodectism caused by this spider. • Latrodectism is a clinical syndrome caused by spider of genus latrodectus. • In Italy L. tredecimguttatus bite may cause severe clinical feature mainly in children or the elderly. • Latrodectism should be suspected when there is a specific clinical picture expecially in patients coming from the countryside. • Specific antidote is not available in Italy, at the present time. • The use of the antidote rise against Latrodectus mactans has been effective in this clinical case. [ABSTRACT FROM AUTHOR]

Zvonimir Maretić was the pioneer of the study of venomous animals and plants, toxicology, and tourism medicine. His achievements have been recognized, but insufficiently researched. His work covers a broad range of biomedical sciences: from public health, ecology, and environmental protection, to epidemiology and infectology. Maretić was one of the founding members of the International Society on Toxinology and the Toxicon journal's first Editorial Board. He was the first in Europe to prepare the antilatrodectic serum and to successfully apply the weever and scorpionfish antiserum on humans. This brief note tries to commemorate the achievements of Maretić, up to now poorly recognized and insufficiently researched. [ABSTRACT FROM AUTHOR]

Some of the world’s most dangerous spiders have been certified in some areas of Iran. Spider bites are common in some geographical areas, and are sporadic in some regions. Spider bites can be classified as latrodectism or loxoscelism. If the patient had not seen the spider, the clinical manifestations of latrodectism could be easily mistaken for other types of bite or sting; or an infectious disease, and withdrawal symptoms, and also loxoscelism could be mistaken for cellulitis, various types of skin infection, or even a sting from a Gadim scorpion (Hemiscorpius lepturus). Given the nonspecific presentation of spider bites, one must keep the diagnosis in mind, and question patients, regarding possible exposure to spiders. Physicians recommend becoming familiar with the geographical distribution of Iranian dangerous spiders, clinical manifestations, and management of their bites. The most useful treatment for spider bite is anti-venom administration. Producing spider bite anti-venom in the Razi Vaccine and Serum Research Institute is under investigation.

Black widow spider bites are uncommon in South Africa, but it is important for clinicians to be aware of the clinical presentation in order to initiate appropriate treatment. This case highlights the presentation and management of a middle-aged gentleman who presented to the Chris Hani Baragwanath hospital following a spider bite. The bite was later confirmed to be that of a black widow spider. The patient presented with the typical symptoms of latrodectism – autonomic dysfunction, muscle rigidity and cramps – and was managed symptomatically with a favourable outcome.

Some of the world’s most dangerous spiders have been certified in some areas of Iran. Spider bites are common in some geographical areas, and are sporadic in some regions. Spider bites can be classified as latrodectism or loxoscelism. If the patient had not seen the spider, the clinical manifestations of latrodectism could be easily mistaken for other types of bite or sting; or an infectious disease, and withdrawal symptoms, and also loxoscelism could be mistaken for cellulitis, various types of skin infection, or even a sting from a Gadim scorpion (Hemiscorpius lepturus). Given the nonspecific presentation of spider bites, one must keep the diagnosis in mind, and question patients, regarding possible exposure to spiders. Physicians recommend becoming familiar with the geographical distribution of Iranian dangerous spiders, clinical manifestations, and management of their bites. The most useful treatment for spider bite is anti-venom administration. Producing spider bite anti-venom in the Razi Vaccine and Serum Research Institute is under investigation. [ABSTRACT FROM AUTHOR]

The patient was an 18-year-old man who developed nephrotic syndrome after a 'wheat spider' bite (Latrodectus mactans). Due to this atypical manifestation of latrodectism, a renal biopsy was performed showing minimal change disease. The nephrotic syndrome subsided after 1 week without specific treatment. This self-limited evolution suggests that the mechanism of podocyte damage was temporary and potentially mediated by a secondary mechanism of hypersensitivity or direct effect of the α-latrotoxin. The patient did not show signs of relapse in subsequent checkup. This is the first reported case of nephrotic syndrome due to a minimal change lesion secondary to latrodectism. [ABSTRACT FROM AUTHOR]

The genus Latrodectus has not been studied in Colombia even though it is medically important worldwide; there are three species for the country, this study focused on a non-identified species found in the Tatacoa Desert in the Huila Department. This research is the first approximation to the extraction, composition analysis and toxicity evaluation of the venom of a species of the genus Latrodectus in Colombia; and aims to evaluate the toxicity by the initial characterization of its venom. The venom extraction was accomplished with electrostimulation and total protein concentration was determined by the Lowry method and BCA assays from crude venom; with these methods, high protein concentration of the samples was measured. Bioassays on mice were also made to evaluate the toxicity and compare the symptoms produced by this Colombian spider to the Latrodectism Syndrome. Finally, an SDS-PAGE electrophoresis was used to separate the main components of high molecular weight from the samples and compared to a control of the venom of Latrodectus mactans to determine if the venom composition is different between these two species. [ABSTRACT FROM AUTHOR]

Widow spiders (Latrodectus spp.), also known as "black widows", have a worldwide distribution and can cause latrodectism. To the best of our knowledge, in Brazil, only one case of Latrodectus geometricus (Koch, 1841) envenomation in a human has been reported. The aim of the present report is to describe a spider bite caused by Latrodectus geometricus in a patient who lives in Paranapanema, São Paulo state, Brazil.

Black widow spider bites are uncommon in South Africa, but it is important for clinicians to be aware of the clinical presentation in order to initiate appropriate treatment. This case highlights the presentation and management of a middle-aged gentleman who presented to the Chris Hani Baragwanath hospital following a spider bite. The bite was later confirmed to be that of a black widow spider. The patient presented with the typical symptoms of latrodectism - autonomic dysfunction, muscle rigidity and cramps - and was managed symptomatically with a favourable outcome. [ABSTRACT FROM AUTHOR]

The first case of envenoming by Latrodectus geometricus in Venezuela is described. The accident occurred at the victim's home, in Aragua de Barcelona, Anzoátegui State. The 31-year-old female victim was bitten twice on the left scapular region, in quick succession (within seconds). She developed a hyperactive state of the central, autonomic and peripheral nervous systems with minor local symptoms.Descreve-se o primeiro caso de envenenamento por Latrodectus geometricus na Venezuela. O acidente ocorreu na residência, em Aragua de Barcelona, Estado Anzoátegui. A paciente de 31 anos de idade foi picada, consecutivamente duas vezes, em segundos, na região escapular esquerda. Ela desenvolveu um quadro de hiperatividade do sistema nervoso central, autonômico e periférico com escassa sintomatologia local.

O trabalho apresenta um estudo retrospectivo de setenta e sete casos de latrodectismo no Estado da Bahia, Brasil, de agosto de 1980 a julho de 1990. Os dados foram levantados nos livros de registro e arquivo de fichas do CIAVE. O agente etiológico em 28% dos acidentes aracnídeos foi a espécie L. curacaviensis e a maior incidência foi registrada no meio urbano (57%), em indivíduos do sexo masculino (70%) e faixa etária de 10 a 29 anos (58%). Os principais sinais locais foram dor (56%), pápula eritematosa (21%) e edema discreto (17%), e os sistêmicos foram dor em membros inferiores (29%), tremores e contraturas (29%), sudorese (28%) parestesia em membros (21%) e dor abdominal (17%). O tratamento foi sintomático em 67% dos casos e específico em 21%. O tempo de permanência hospitalar após o uso do soro antilatrodectus foi menor que 24 horas em 64% dos casos.This work is a retrospective study of latrodectism in the State of Bahia, Brazil, from August 1980 to July 1990. The data concerning the accidents were obtained from file cards at the Antivenom Information Center of Bahia (AVICB). Latrodectus curacavienis was the ethiologic agent identified in 28% of the arachnid accidents. The major incidence was registered in urban area (57%) affecting men (70%) more than women, with 10 to 29year-old age group (58%). Local pain (56%), erythematous papula (29%) and light oedema (17%) were the principal local symptoms. Pain in the limbs (29%), tremor and rigidities (29%), sweating (28%), limbs and arms paresthesia (21%) and abdominal pain (17%) were systemic ones. The treatment was mainly symptomatic (67%) and antivenin serum was used in 21% of the cases. After serotherapy, 64% of the patients left the hospital within less than 24 hours.

The genus Latrodectus contains the most medically important spiders around the world. This study describes the first case of Latrodectus cinctus Blackwall, 1865 bite and clinical treatment from Iran. Also, it is the first collection report from the southeast of the country that can enhance prior knowledge on the geographical distribution of this species. We describe a 42-year-old female patient with neurological pain caused by the spider bite. Also, a summary of the entomological survey and morphological identification of the collected species from the patient's house is presented., (© The Author(s) 2022. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Copyright of Intensivmedizin und Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Alpha-latrotoxin (α-ltx), a component of the venom of black widow spiders (BWSV), binds to higher vertebrates presynaptic nerve terminals, stimulating massive neurotransmitter release. This neurotoxic protein is responsible for most of the symptoms elicited in men by the bite of black widow spider (BWS), i.e. a neurological syndrome named latrodectism. By reasoning that targeting this single component would abrogate most of the effect of BWS envenomation, we took advantage of the antibody phage display technology to generate monoclonal Fab fragments able to bind and neutralize the α-ltx. To this aim, we immunized Balb/c mice with purified toxin and cloned their antibody repertoire in the pCombIII phage display vector. By combining a high-stringency affinity selection with a sensitive 45Ca2+ uptake assay, we isolated a Fab fragment (FM1) able to bind the α-ltx in the low nM range and neutralize its ionophore activity, in vitro and in vivo. After the onset of overt symptomatology, administration of FM1 to experimentally envenomed mice induced remission of symptoms and prevented lethality. Since α-ltx is the only molecule responsible for the great toxicity of BWS bites in mammals, the FM1 Fab, highly effective in neutralizing the toxin in vivo, represents a promising immunotherapy reagent for treating latrodectic patients. [Copyright &y& Elsevier]

To compare the efficacy of intravenous versus intramuscular antivenom (AV) in the treatment of Red-back spider (RBS) envenoming.Randomized, double-dummy, double-blind, multicentre trial of patients with red-back spider envenoming requiring AV treatment recruited from five hospital EDs in Western Australia.Thirty-five patients were recruited; two were excluded; 33 were available for initial analysis, but two who were unblinded after one ampoule of trial AV and given i.v. AV had limited data; 31 remained in the study and had more complete data. After AV, pain scores for both i.m. and i.v. groups improved rapidly. At 24 h, the i.v. group was better with a 55% absolute difference (76% vs. 21%; 95% CI 25–85% difference) in the proportion pain-free. There were no safety issues.Red-back spider antivenom was initially effective by both i.m. and i.v. routes. The study generates the hypothesis that at 24 h, significantly more patients are pain-free with i.v. administration. Definitive recommendations on the optimal route of administration of RBS AV await the results of further studies. [ABSTRACT FROM AUTHOR]

To describe the clinical effects of spider bites in a paediatric population and compare to bites in an adult population. Prospective follow up study of children with definite spider bites where the spiders were immediately collected and expertly identified. Cases were recruited from Australian emergency departments and poison information centres and followed up. Data were collected on circumstances of bites and clinical effects, and compared with similar data from adult spider bites. There were 163 cases (62% male, 38% female; age <16, median age 7 years, interquartile range (IQR): 3−11 years). The median duration of effects was 2 h (IQR 0.25−12 h). The commonest spiders were Huntsman spiders ( Sparassidae) and Orb weavers ( Araneidae), and comparatively few bites by theridiid spiders, including Red-back spiders. Pain or discomfort occurred in all bites and was severe in 20%. Local effects included puncture marks/bleeding (36%) and red mark/redness (73%). Systemic effects occurred in only 6% of cases. There were no necrotic lesions or ulcers as a consequence of any spider bites (0%; 97.5% CI 0.0−2.2%) and no early allergic reactions or secondary infections. The median duration of clinical effects was shorter than adults, the frequency of severe pain was less than adults and systemic effects were less common in children. Paediatric spider bite causes minor effects in the majority of cases, and is unlikely to cause necrotic ulcers, allergic reactions or infection. The severity and duration of effects differ from adults. [ABSTRACT FROM AUTHOR]

Spider bite continues to be a controversial subject worldwide and attribution of clinical effects to different spiders is problematic because of poor case definition and paucity of clinical evidence. The effects of medically important spiders are sometimes underestimated and simultaneously there is misattribution of effects to harmless spider groups. The majority of suspected spider bites present as skin lesions or necrotic ulcers where the history of a spider bite must be confirmed. To be a definite spider bite, the patient must immediately observe the spider and there be evidence of the bite, such as pain. Important groups of spiders worldwide include the widow spiders (latrodectism), recluse spiders (loxoscelism) and some mygalomorph spiders including the Australian Funnel web spider. Most spiders only cause minor effects, including a large number of groups that have been implicated in necrotic arachnidism. [Copyright &y& Elsevier]

Abstract Four cases of Red-back spider envenoming are reported in which there was minimal response to intramuscular antivenom. Intravenous antivenom was then administered in each case with almost complete resolution of symptoms. All cases were followed up to confirm the effect of treatment. This failure of intramuscular Red-back antivenom raises the question of its efficacy. There has been no controlled trial to prove that intramuscular Red-back antivenom is effective and animal work with other antivenoms has demonstrated the intramuscular formulation to have delayed and incomplete effects. Controlled studies should be undertaken to establish the effectiveness of intravenous and intramuscular Red-back antivenom. [ABSTRACT FROM AUTHOR]