Loxoscelismo en pediatría: Región Metropolitana, Chile

Loxoscelism is the toxic picture produced by the venom of spiders of genus Loxosceles, in Chile L. laeta. It may presents in two clinical forms, cutaneous loxoscelism (CL) and viserocutaneous loxoscelism (VCL). The objective of this paper is to present and analyze the clinico-epidemiological aspects of 56 paedriatric cases, 38CL and 18 VCL treated in the Metropolitan Region. The highest incidence of both forms was in spring-summer, and in bedrooms when the child was sleeping or dressing. The skin of the limbs and face were most frequently affected with a burning stinging sensation as the initial symptom. Local clinical manifestations were, pain, oedema and a livedoid plaque most of which evolved into a necrotic scar, in VCL, hematuria, hemoglobinuria, jaundice, fever and sensorial involvement, with a mortality of 22.2%. The occurence of VCL had no relationship with the size of the bite, size of the local lesion or season. If visceral involvement does not appear within the first 24 hours it is most probably that the diagnosis is CL, with a good prognosis. If a patient with VCL survives 48 hours the possibilities of recovery are high. Patients were parenterally treated with antihistamines or steroids in CL and steroids in VCL. Conclusion: In this serie there was a female predominance, without seasonal differences or differences in age. The majority of cases occurred at home, affecting prinicipally the extremieties. VCL was more frequent in girls, heamaturia and hemoglobinuria the most frequent manifestations. Early diagnosis and treatment are fundamental for the prognosis.