Latrodectismo en niños: Un enemigo pequeño con grandes consecuencias

Latrodectismis a clinical syndrome caused by the bite of the spider of the Latrodectus genus, whose largest representative is the Latrodectus Mactans, or "black widow." Two varieties have been described in Ecuador; however, no reports have been found for the pediatric population within the reviewed bibliography.The objective of this report is to alert about the presence of this clinical entity in children, given its potential lethality, although rare, in addition, to describe the clinical and therapeutic characteristics. The clinical histories of pediatric cases of spider bites in a hospital in the province of Tungurahua were reviewed, during the biennium January 2022 to January 2024. Four cases were found, three boys aged 4, 10, 11 and a 13-year-old girl. The inoculation site was on the hands in all cases, the accident with the spider was outside the home, in a rural area with vegetation; at a geographic altitude of 2,600 to 3,100 meters above sea level in the Andean zone of the country. The degree of poisoning was moderate in three cases and mild in the remaining one. The clinical picture is that described in latrodectism, in addition to local signs of edema and pain in the hands, it included neurological and cardiovascular manifestations such as facial flushing, tremor, muscle spasms, tachycardia, cyanosis, and dyspnea. The evolution was favorable with the use of corticosteroids, intravenous analgesics, antihistamines, calcium gluconate and the provision of fluids and electrolytes.