Loxoscelism in Chile: epidemiological, clinical and experimental studies

Abstract

A panoramic sight of epidemiological, clinical and experimental studies, referring to Loxosceles laeta and loxoscelism, carried out in 1955-1988, in Santiago, Chile is presented. Two-hundred and sixteen cases of loxosce lism were studied. The most relevant features were: 84.3% corresponded to cutaneous loxosce lism (CD and 15.7% to viscerocutaneous loxos celism (VCD; 73.6% ocurred in hot season; in 86.6% of cases the accident happened in the hou se, particularly in bedrooms, while the people were sleeping or dressing. The spider was seen in 60.2%r of cases and identified in the laboratory as L. laeta in 10.69c of all cases. The sites more frequently bitten were the limbs with 67.6% ; a burning stinging was the most frequent initial symptom. Pain, edema and livedoid plaque, which developed later into a necrotic eschar, we re the predominant local manifestations. In VCL, hematuria and hemoglobinuria were cons tant, while jaundice, fever and sensorial involve ment were present in most of the cases. CL patients were parenterally treated with antihistamine drugs or corticoids, while VCL ones were treated with corticoids by injection. The condition of patients in the last follow up was: complete cure in 75.5% , cure with a scarfed sequela in 8.3%, death in 3.7% (all VCL) and abandonment in 12.5%. Additionally, a series of experimental studies, both in vivo and in vitro, has been performed in order to clarify basic aspects on L. laeta venom and the treatment of loxoscelism.