Clinical characteristics of redback spider bites.

Toru Hifumi,Kyoko Sawabe,Yasuhiro Kuroda,Keigo Shibayama,Yuichi Koido,Satoru Arai,Akihiko Yamamoto,Masanobu Kishikawa,Akihiko Ginnaga,Masanobu Hagiike,Satoshi Fujimi,Hiroshi Kato,Takuya Yamagishi,Junichi Inoue,Manabu Ato,Yuko Abe,Kenya Kawakita,Nobuaki Kiriu

doi:10.1186/s40560-014-0062-3

Abstract

BackgroundRedback spiders (Latrodectus hasselti) (RBSs) are venomous spiders that have recently spread to Asia from Australia. Since the first case report in 1997 (Osaka), RBS bites have been a clinical and administrative issue in Japan; however, the clinical characteristics and effective treatment of RBS bites, particularly outside Australia remains unclear. This study aimed to elucidate the clinical characteristics of RBS bites and to clarify the effectiveness of the administration of antivenom for treatment.MethodsWe performed a retrospective questionnaire survey from January 2009 to December 2013 to determine the following: patient characteristics, effect of antivenom treatment, and outcomes. To clarify the characteristics of patients who develop systemic symptoms, we compared patients with localized symptoms and those with systemic symptoms. We also examined the efficacy and adverse effects in cases administered antivenom.ResultsOver the 5-year study period, 28 patients were identified from 10 hospitals. Of these, 39.3% were male and the median age was 32 years. Bites most commonly occurred on the hand, followed by the forearm. Over 80% of patients developed local pain and erythema, and 35.7% (10 patients) developed systemic symptoms. Baseline characteristics, vital signs, laboratory data, treatment-related factors, and outcome were not significantly different between the localized and systemic symptoms groups. Six patients with systemic symptoms received antivenom, of whom four experienced symptom relief following antivenom administration. Premedication with an antihistamine or epinephrine to prevent the adverse effects of antivenom was administered in four patients, which resulted in no anaphylaxis. One out of two patients who did not receive premedication developed a mild allergic reaction after antivenom administration that subsided without treatment.ConclusionsApproximately one third of cases developed systemic symptoms, and antivenom was administered effectively and safely in severe cases. Further research is required to identify clinically applicable indications for antivenom use.

Highlights

Redback spiders (Latrodectus hasselti) (RBSs) are venomous spiders that have recently spread to Asia from Australia
Since the first case reported in Osaka in 1997, RBS bites have been a clinical and administrative issue in Japan [8,9]
Over 80% of patients developed local pain and erythema, and systemic symptoms occurred in 10 patients (35.7%)

Summary

Introduction

Redback spiders (Latrodectus hasselti) (RBSs) are venomous spiders that have recently spread to Asia from Australia. Since the first case report in 1997 (Osaka), RBS bites have been a clinical and administrative issue in Japan; the clinical characteristics and effective treatment of RBS bites, outside Australia remains unclear. This study aimed to elucidate the clinical characteristics of RBS bites and to clarify the effectiveness of the administration of antivenom for treatment. Redback spiders (Latrodectus hasselti) (RBSs) are venomous spiders that produce the neurotoxin (alpha-latrotoxin) [1]. Since the first case reported in Osaka in 1997, RBS bites have been a clinical and administrative issue in Japan [8,9]. The clinical characteristics and optimal treatment of RBS bites, outside Australia remain unknown

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