Abstract

QUERO HERNANDEZ, Armando; ZARATE ASPIROS, Romeo  and  PEREZ BAUTISTA, Aarón. Aracnoidismo necrótico. Bol. Med. Hosp. Infant. Mex. [online]. 2004, vol.61, n.2, pp.160-163. ISSN 1665-1146.

Introduction. The bite for the spider Loxosceles reclusa causes lesions quickly progressive necrotics that end up even causing amputation of the affected extremity, or to give origin to systemic manifestations, being expressed with intravascular hemolysis, coagulopathy, renal failure and rarely the patient's death. The use of the dapsone in the cases of local affection has been able to limit the necrotic lesion and to avoid loss of the extremity. The clinical case of an infant is presented that presented necrotic lesion with appropriate response to the therapy with dapsone. Case report. Female infant of 9 months of age, seen in the Emergency Department of the General Hospital Dr. Aurelio Valdivieso of the State of Oaxaca, with a clinical picture of 48 hours of evolution characterized by vesicle in right leg; 24 hours later it presented erythematous, besides intense pain, limitation for the mobilization of the affected extremity and edema. To the physical exploration tachycardia was observed, in half third of leg right erythematous lesion of not well defined borders, vesicles with tendency to converge, with increase of the local heat, and the third cold distal and palpable pulses. Handling began with dicloxacilin and amikacin with presumptive diagnosis of cellulitis. One day later the area you went violaceous, with phlyctenas and the denuded central part that it embraced a diameter of 10 cm. With the suspicious of necrotic arachnidism dapsone was administered, requiring debridement until deep planes. The evolution was satisfactory, being conserved the extremity. Conclusion. In patients that present necrotic lesions, quickly progressive with or without systemic affection, to consider the possibility in the differential diagnosis of loxoscelism and necrotic arachnidism.

Keywords : Loxoscelism; necrotic arachnidism; dapsone.