ЦРНА ВДОВИЦА ПАЈАЦИ ВО МАКЕДОНИЈА - ЛАТРОДЕКТИЗАМ И ТЕРАПИЈА ( приказ на 3 случаи)

Abstract

The aim of this paper was to present three cases of poisoning with Black Widow spider’s venom (Latrodectus mactans tredecimguttatus) in the Republic of Macedonia and different intensity of clinical features of latrodectsm and its complications. All patients developed “target” lesion. Within one hour they presented with hypertoxic myopathic syndrome with painful cramps, “facies latrodectismica”, autonomic-vegetative effects and life-threatening complications: High hypertension (2 patients) and acute pulmonary toxic oedema (1 patient). It was confirmed at the Faculty of Biology in Skopje that the incriminated spider in the third patient was Latrodectus mactans tredecimguttatus and that its presence was registered for the first time at this territory. Treatment involves local wound care, tetanus prophylaxis, symptomatic therapy and abandoning Ca-gluconate as an antidote. Because of severe allergic reaction, indication for Latrodectus antivenom administration (crude hyperimmune horse serum) (USA) is still controversial with a strong effort for its use in endemic regions (USA, Croatia, Australia).