r.xkm.1976, vol. 14, pp . 392-M. P«gamm pus&
mes la Grat araediz.
A BITE BY THE SPIDER ARANEA SEXPUNCTATA LINNÉ : CASE REPORT Zvoxumm MARSTI6 and OLGA Mu naA
Medical Centre, Pula, Yugoslavia and Iadustrial Health Unit, Factory "17OT", Zagreb, Yugoslavia (Accepted for pubUaadon 10 February 1976)
all spiders have a venom apparatus, except for two small groups, and are in principle venomous, for various reasons, most of them are considered harmless to man. The life habits of some species or their timidity prevents them from coming into contact with man, while others have fangs which are too weak or too short to penetrate the human skin. The venom of some may be toxic only for some species of animals. However, from time to time species of spiders are found to be dangerous following bites on mammals, not only in tropical areas, but also in Europe (MARMC et al., 1964). Aranea sexpunctata Linn6 (Araneida) is a common European spider and has been considered harmless to man. However, the present case indicates this may not be so. The accident occurred in a pencil factory in Zagreb (Croatia, Yugoslavia) which has a middle European climate. Latrodectus species do not occur naturally in this area. M. K., a 35-year-old female was bitten on the left arm by a black spider on 2 June 1975 at 10.00, while working on a motor in the factory. The spider clung to the skin, even after being partially crushed by the patient. The victim experienced immediate localized pain and soon after, a feeling of pressure and choking in the chest. This was followed by some rigidity, weakness and paresthesia in the injured limb and then in all limbs, together with a generalized pruritus within 15 min of the bite. When the patient was fast seen in the medical visiting room of the factory at 10.35, she was hardly able to stand. She was restless, confused, frightened and shedding tears. She complained of fairly strong pain in the lumbar region and abdomen, the latter being somewhat rigid and tender. A diffuse redness was present over the face, and blepharoconjunctivitis. Salivation was increased, moderate sweating was present and some nausea. Arterial pressure was 136/94 with moderate tachycardia. Respirations were shallow and increased. At the site of the bite there was a 3 x 3 cm reddened and slightly edematous wheal . The patient was treated with an injection of an intramuscular steroid and antihistamine and 10 ml of i.v. calcium gluconate. The patient obtained some relief following the injection of the calcium gluconate. The next day the patient complained of pain in her feet with intense `burning' of the soles. Four days later the patient still had some difficulty in walking, along with some deep muscular pain in the legs, with paresthesias in all extremities. She was still frightened and complained of insomnia . Urine analysis showed a trace of blood. During this period she lost 4 kg, approximately 8 % of her total body weight . Many of the psychosomatic manifestations persisted for several months, during which time she lost additional weight . ALTHOUGH
7VXZCON 1976 Vol. 14
392
Short Communications
393
The signs and symptoms might lead one to believe that the envenomation was due to Latrodectus. There was some epidemiological support for this supposition, since the wood used in the factory was imported from California but F. E. Russell (personal communica tion) suggests it would be most unusual to find Latrodectus in cedar. Even though imported Latrodectus specimens have been reported as far north as Belgium (BENOrr, 1969), it was not until the remains of the spider were examined by Prof. Dr. Anton Polenec, director of the Museum of Natural history of Slovenia (Ljubljana), that the spider was positively identified as Aranea sexpunctata. This case again points out the importance of encouraging the patient to bring the offending arthropod to the physician for identification and to avoid making a diagnosis based on a few symptoms and signs, which can often be misleading, particularly when the offending arthropod has not been identified, a point stressed by RussE
mes la Grat araediz.
A BITE BY THE SPIDER ARANEA SEXPUNCTATA LINNÉ : CASE REPORT Zvoxumm MARSTI6 and OLGA Mu naA
Medical Centre, Pula, Yugoslavia and Iadustrial Health Unit, Factory "17OT", Zagreb, Yugoslavia (Accepted for pubUaadon 10 February 1976)
all spiders have a venom apparatus, except for two small groups, and are in principle venomous, for various reasons, most of them are considered harmless to man. The life habits of some species or their timidity prevents them from coming into contact with man, while others have fangs which are too weak or too short to penetrate the human skin. The venom of some may be toxic only for some species of animals. However, from time to time species of spiders are found to be dangerous following bites on mammals, not only in tropical areas, but also in Europe (MARMC et al., 1964). Aranea sexpunctata Linn6 (Araneida) is a common European spider and has been considered harmless to man. However, the present case indicates this may not be so. The accident occurred in a pencil factory in Zagreb (Croatia, Yugoslavia) which has a middle European climate. Latrodectus species do not occur naturally in this area. M. K., a 35-year-old female was bitten on the left arm by a black spider on 2 June 1975 at 10.00, while working on a motor in the factory. The spider clung to the skin, even after being partially crushed by the patient. The victim experienced immediate localized pain and soon after, a feeling of pressure and choking in the chest. This was followed by some rigidity, weakness and paresthesia in the injured limb and then in all limbs, together with a generalized pruritus within 15 min of the bite. When the patient was fast seen in the medical visiting room of the factory at 10.35, she was hardly able to stand. She was restless, confused, frightened and shedding tears. She complained of fairly strong pain in the lumbar region and abdomen, the latter being somewhat rigid and tender. A diffuse redness was present over the face, and blepharoconjunctivitis. Salivation was increased, moderate sweating was present and some nausea. Arterial pressure was 136/94 with moderate tachycardia. Respirations were shallow and increased. At the site of the bite there was a 3 x 3 cm reddened and slightly edematous wheal . The patient was treated with an injection of an intramuscular steroid and antihistamine and 10 ml of i.v. calcium gluconate. The patient obtained some relief following the injection of the calcium gluconate. The next day the patient complained of pain in her feet with intense `burning' of the soles. Four days later the patient still had some difficulty in walking, along with some deep muscular pain in the legs, with paresthesias in all extremities. She was still frightened and complained of insomnia . Urine analysis showed a trace of blood. During this period she lost 4 kg, approximately 8 % of her total body weight . Many of the psychosomatic manifestations persisted for several months, during which time she lost additional weight . ALTHOUGH
7VXZCON 1976 Vol. 14
392
Short Communications
393
The signs and symptoms might lead one to believe that the envenomation was due to Latrodectus. There was some epidemiological support for this supposition, since the wood used in the factory was imported from California but F. E. Russell (personal communica tion) suggests it would be most unusual to find Latrodectus in cedar. Even though imported Latrodectus specimens have been reported as far north as Belgium (BENOrr, 1969), it was not until the remains of the spider were examined by Prof. Dr. Anton Polenec, director of the Museum of Natural history of Slovenia (Ljubljana), that the spider was positively identified as Aranea sexpunctata. This case again points out the importance of encouraging the patient to bring the offending arthropod to the physician for identification and to avoid making a diagnosis based on a few symptoms and signs, which can often be misleading, particularly when the offending arthropod has not been identified, a point stressed by RussE
