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Diagnóstico y tratamiento del latrodectismo en urgencias

Authors: Gerardo A. Orihuela-Anaya;

Diagnóstico y tratamiento del latrodectismo en urgencias

Abstract

Se denomina latrodectismo a los signos y síntomas causados por la inoculación del veneno de las arañas del género Latrodectus sp. también llamadas «viudas negras». Es una patología altamente incapacitante, caracterizada por dolor local y generalizado muy intenso, diaforesis, ansiedad, espasmos, calambres musculares y otros signos y síntomas neurológicos de predominio autonómicos, que suele confundirse en el abordaje diagnóstico inicial con otras patologías agudas graves como isquemia coronaria, abdomen agudo, toxíndromes y cólico renal. El diagnóstico es clínico y se basa en la presencia de los signos y síntomas clásicos en el paciente y el antecedente de contacto traumático con la araña, aunque en los casos en que la agresión no se identifique o pase desapercibida es importante considerar el latrodectismo como un diagnóstico diferencial en áreas endémicas y extremos de la vida. Los estudios paraclínicos rara vez son útiles para el diagnóstico. El tratamiento se basa en el uso de antiveneno o faboterapia específica, con analgesia opioide y benzodiazepinas como alternativa si no se dispone del antídoto o como terapia adyuvante. Los esteroides, calcio, antihistamínicos y antibióticos no se recomiendan por su nula efectividad. Este artículo tiene como objetivo revisar las principales características del latrodectismo, desde su etiología, epidemiología, así como las recomendaciones diagnósticas y de tratamiento actuales disponibles en la literatura para que sirvan de guía en la práctica diaria en el servicio de urgencias, ya que el abordaje precoz permitirá acortar los síntomas y prevenir potenciales complicaciones en el paciente.

Keywords

RC86-88.9, Latrodectismo. Latrodectus sp. Viuda negra. Envenenamiento. Alfa-latrotoxina. Faboterapia. Antiveneno., Medical emergencies. Critical care. Intensive care. First aid

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold