Case Reports in Medicine / 2012 / Article / Tab 1

Case Report

Reversible Myocarditis after Black Widow Spider Envenomation

Table 1

Cases of spider Bite envenomation with myocarditis involvement.

Age/sexBite siteSpider speciesClinical featuresLab findings

15/MRt big toeBlack widow spider (BWS)Local pain; back pain; priapism; abdominal cramps; progressive paresthesia; dyspnea/restlessness; rigors; pulmonary edemaLeukocytosis 18,000; ECG: T-inversion in 1, AVL; S-T elevation: AVL, V2, V3; highly elevated CK: 2085 IU/L; chest X-ray: pulmonary edema; ECHO: bacmyocardial dysfunction; low ejection fraction 0.264

22/MLeft thighBWS (Latrodectus Hesperus)Back and abdominal pain, tremors, diaphoresis, paresthesias, periorbital edema, diffuse muscle fasciculations, pulmonary edemaECG: incomplete right bundle branch block with ST elevations in the precordial leads, CPK: 243 IU/L, troponin 1c: 1.37 ng/mL ECHO: low LVEF:35–40

16/MBWSTypical chest painECG: ST-T changes in precordial leads Echo: akinesia of interventricular septum with depressed left ventricular function

65/Mleft footBWSVomiting, nausea, chest pain.ECG: 0.5-mm ST-segment elevation in leads II, aVF, and V3 through V6 and accompanying augmentation in T-wave amplitude in leads V3 through V6 Troponin: 6.1 ng/mL Echo: normal

22/Mleft shoulderBWSAnxiety, severe hypertension, nausea, vomiting, tremor, generalized pain,diaphoresis, and rhabdomyolysisTroponin I: 0.75 ng/mL, ECG: atrial depolarizationabnormalities in leads D II, III, and aVF, and depolarization abnormalities in leads V1 and aVL. LVEF: 50%, anterior and septal wall motion abnormality

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