Differential Hematotoxic Activity of Southeast Asian Pit Viper Venoms: The Cross-Neutralizing Effect of Available Antivenoms

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  Image Credit: Creative Commons (some rights reserved) CC BY-NC Photo 111998430, (c) Nicholas Hess Differential Hematotoxic Activity of Southeast Asian Pit Viper Venoms: The Cross-Neutralizing Effect of Available Antivenoms Abstract Background/Objectives : Pit vipers (subfamily Crotalinae) are responsible for a large proportion of snakebite envenoming cases in Southeast Asia. Envenomation by these snakes commonly causes hematotoxic effects, including platelet dysfunction and coagulation disturbances. Although antivenom remains the mainstay of treatment, species-specific antivenoms are not available for several regional pit viper species. This study evaluated the hematotoxic activities of selected Southeast Asian pit viper venoms and the cross-neutralizing capacity of commercially available antivenoms.  Methods : Venoms from five medically important pit viper species— Calloselasma rhodostoma ,  Trimeresurus albolabris ,  T. hageni ,  T. purpureomaculatus , ...

Black Widow Spider Exposures: A Retrospective Review of the National Poison Data System 2012–2022

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Black Widow Spider Exposures: A Retrospective Review of the National Poison Data System 2012–2022

Abstract

Introduction

The black widow spider, Latrodectus mactans, stands out as one of the most medically significant arachnids due to its extensive geographic distribution in the United States and its ability to produce a potent neurotoxin, α-latrotoxin. This study aimed to describe the epidemiology of black widow spider exposures by month of exposure, geographic distribution, demographics, symptoms, treatment, and health system resource utilization between 2012 and 2022.

Methods

This was a retrospective observational study using the US National Poison Data System, the data warehouse of the 55 US poison centers. A descriptive analysis of patient demographic data, month of exposure, clinical effects, level of healthcare received, and medical outcome was performed.

Results

During the studied period, a total of 15,299 cases of Latrodectus spp exposures were reported to US poison centers. Exposures occurred with higher frequency in warm-weather states and during summer months. Almost half the cases were managed outside a healthcare facility (48.6%). Hospital admission was required for 10.0% of exposures. The most common therapies received were wound care (43.7%) and benzodiazepines (18.6%). Antivenom was administered in 3.4% (n=521) of exposures.

Conclusions

Poison center data indicate that most black widow spider exposures result in minor consequences. Supportive care is the primary approach for black widow spider bites. Although antivenom use is infrequent, providers may seek administration guidance from toxicologists through local poison centers. This study underscores the pivotal role of poison centers in mitigating unnecessary healthcare visits and subsequent hospitalizations.

Kerns AF, Scheffel ET, Farah R, Holstege CP. Black Widow Spider Exposures: A Retrospective Review of the National Poison Data System 2012–2022. Wilderness & Environmental Medicine. 2024;0(0). doi:10.1177/10806032241300134