Muso cɛ salen nɛrɛma ni araignée recluse brun ka kinni: Muscle cramping Rigidity vs Necrotic Skin ulcers¶

Ameriki, Ɔsitarali, Erɔpu ani Afiriki jamanaw bɛɛ la, wuluw ka kinni minnu nafa ka bon furakɛli siratigɛ la, olu bɛ tila ka kɛ kɛnɛyako taamasiɲɛ fila ye minnu tɛ kelen ye pewu: latrodectisme neurotoxic min bɛ bɔ Widow ni Redback wuluw la (Latrodectus suguya) ani cytotoxic loxoscelism min bɛ bɔ Recluse walima Violin wuluw la (Loxosceles suguya). Black Widow walima Australian Redback bɛ alpha-latrotoxin pikiri kɛ, o ye presynaptic neurotoxin ye min bɛ kɛ sababu ye ka pinprick nɔgɔlen teliya la min bɛ tugu miniti 30 fo 90 kɔnɔ ni kolotugudaw kirinni ye min bɛ mɔgɔ tɔɔrɔ, i n’a fɔ jikuru, kɔnɔbara kogo gɛlɛn min bɛ i n’a fɔ pankurun min bɛ appendix karilen ladege kosɛbɛ, ji min bɛ mara kɔnɔ sumaya, ani tansiyɔn jiginni jugumanba, ka sɔrɔ a bɛ se ka kɛ ko fari tiɲɛni tɛ to kinni yɔrɔ la. O cogo kelen na, Brown Recluse wulu bɛ sphingomyelinase D (phospholipase D) pikiri kɛ, o ye farikolo yɔrɔw tiɲɛni anzimu ye min ka teli ka dimi pewu a kinni waati la, nka a bɛ wuli lɛri 6 fo lɛri 72 kɔnɔ ka kɛ laɲini plaque bilenman, finman ani bulu ye ni eschar necrotic nɛrɛmuguma jiginnen ye, wa kɛmɛsarada la 1 fo 10 bɛ ɲɛnamaya-ko-banakisɛ-banakisɛ-banakisɛ bila mɔgɔ la joli-sira-funu jugumanba (hémoglobinurie brun dibima, jaŋɔyin, ani sugunɛbaralabana), kɛrɛnkɛrɛnnenya la denmisɛnw na. A nafa ka bon kosɛbɛ, banabagatɔw ye dimi bilenman funu minnu sɔrɔ i n’a fɔ wuluw ka kinni, olu kɛmɛsarada la, 80 ni kɔ ye farikolojidɛsɛw ye minnu bɛ sɔrɔ sigida la, minnu bɛ se ka mɛtisilini kɛlɛ Staphylococcus aureus (CA-MRSA) farikolojidɛsɛw. Ni kinnikɛla dɔ ye kɔnɔbara walima kɔdimi jugumanba sɔrɔ, ninakili gɛlɛyara, sugunɛ bilenman dibiman, walima fari bilenni min bɛ jɛnsɛn joona, aw bɛ aw ka sigida wele kɔrɔtɔko nimɔrɔw o yɔrɔnin bɛɛ. An balimakɛw ka gafew fana lajɛ wuluw ni wuluw ka kinni, . selilulɛti, ɲɛgɛnɛsira bilenmanw, ani farikolojidɛsɛ MRSA, ani sa ka kinni.

Aw ka fɔlɔfɔlɔ teliya ye ka kinni ko nɔgɔya la ni safinɛ ni ji ye, ka komɛsi nɛnɛman walima jisumamugu kɛ min sirilen don fini na (aw kana funteni kɛ abada kinnikɛlan min bɛ a yɛrɛ mabɔ, ani aw kana tourniquet walima Pressure Immobilisation Bandage kɛ abada wulu fila si la), ka farikolo gɛlɛya jiginni walima joli segincogo kɔlɔsi, ani ka dɔgɔtɔrɔso ladonni kɔrɔtɔlen ɲini joli fɛ opioidw ni Latrodectus Antivenom musocɛ salen ka kinni jugumanw na walima joli seginni kɔlɔsili kɛli recluse kinni na.

Aw bɛ o kɛ sisan¶

1. Aw bɛ teliya ka taamasiɲɛw sɛgɛsɛgɛ minnu bɛ se ka mɔgɔ ka ɲɛnamaya bila farati la ani ka aw ka sigida kɔrɔtɔko nimɔrɔ wele ni o bɛ yen. Aw bɛ 911 wele Ameriki ani Kanada, 000 Ɔsitarali, 111 Nuwɛlika, 112 Erɔpu tɔnba bɛɛ kɔnɔ, 999 Angletɛri, walima ka an ka diɲɛ kɔnɔ kunnafonisɛbɛn lajɛ kɔrɔtɔko nimɔrɔw ni a tigi ye dimi jugumanba sɔrɔ kɔnɔbara, kɔ, disi, walima cɛya la, ninakili gɛlɛya, disi gɛlɛya, tansiyɔn jiginni jugumanba, ɲɛnamini, kurukuru caman, farigan, jaŋaniya (ɲɛ jɛman), walima sukili dibiman min bɛ i n’a fɔ te walima kola.
2. Aw bɛ wulu foto ta lafiya la (walima ka na ni a fɛnɲɛnamafagalan mugulen ye daga datugulen kɔnɔ) dɔrɔn ni a bɛ yen yɛrɛ, k’a sɔrɔ i ma farati lase a kinni filanan ma. Kɔnɔnafili ɲuman min bɛ kɛ ni wuluwulu nɛrɛmuguma ye min bɛ manamana ni lɛrɛ bilenman ye (Latrodectus) ni wulu tan ye min taamasiyɛn ye violon dibi ye a kunkolo la ani ɲɛ wɔɔrɔ minnu labɛnna saba ye pairs (Loxosceles) bɛ dɔgɔtɔrɔso baga furakɛli ɲɛminɛ o yɔrɔnin bɛɛ.
3. Aw bɛ kinni yɔrɔ ko dɔɔni dɔɔni ni safinɛ nɔgɔlen ye ani ji nɛnɛman ye, ani ka bololanɛgɛw, watɛsiw, bololanɛgɛw walima sanbara sirilenw bɛɛ bɔ senkɔni kinnalen na. Aw kana a tigɛ abada, ka a tigɛ, ka a sama, ka a jeni, ka kuran sɔgɔli marifaw kɛ a la, walima ka a kinni joginda digidigi abada. Ni Loxosceles kinni dɔ sɔgɔra walima ni a tigɛra, sphingomyelinase D bɛ waajibiya ka taa farikolo jukɔrɔ tulu ni farilajiw la, o bɛ kirinni nekɔrɔsi bonya kosɛbɛ.
4. Aw bɛ fini sanuman nɛnɛman ɲiginnen walima jisumamugu min sirilen don finimugu la (miniti 10 fo miniti 15, miniti 15 dabila) kɛ kinni yɔrɔ la, ani aw kana tasumamugu walima komɛsi sumalen kɛ abada Brown Recluse kinni na min bɛ siga la. Mun na funteni nafa ka bon: anzimu necrotique sphingomyelinase D min bɛ Brown Recluse baga la, o bɛ ni enzymatic ye min bɛ bɔ funteni na kinetiki (kinɛtiki) ye. Fari sumaya bɛ anzimu baara teliya, ka jolisegindumuniw sɔrɔli teliya, ani farikolo yɔrɔw saya, k’a sɔrɔ nɛnɛ nɔgɔman bɛ anzimu sfingolipidiw tigɛcogo sumaya ani ka sigida dimi dɔgɔya musocɛ salen ni musocɛ salenw ka kinni na.
5. Aw kana Pressure Immobilisation Bandage (PIB) walima arterial tourniquet kɛ abada Black Widow, Redback, walima Brown Recluse spider bite kan. Australian Resuscitation Council (ANZCOR Guideline 9.4.2) ani Ameriki Woroduguyanfan toxicologie sariyaw kɔnɔ, Pressure Immobilisation Bandages adant kosɛbɛ Latrodectus (Redback/Widow) ani fila bɛɛ la Loxosceles (Recluse) kinni : muso cɛ salen baga minɛni bɛ dɔ fara sigida dimi jugumanba kan, ani ka recluse baga minɛ, o bɛ farikolo yɔrɔw tiɲɛ yɔrɔ kelen na, o bɛ fari jugumanba juguya. (Kɔlɔsili: PIB bɛ kɛ Australian Funnel-Web wuluw [Atrax / Hadronyche] ani sa kinni na, a tɛ kɛ abada Redback, Widow, walima Recluse wuluw kama.)
6. Aw bɛ sugunɛ kulɛri lajɛ sanuyaso taama bɛɛ la sanga 72 kɔnɔ, aw bɛ siga ko Brown Recluse kinni kɔfɛ, kɛrɛnkɛrɛnnenya la denmisɛnw na. Ni sugunɛ kɛra pinki, bilen, nɔgɔ, walima bulama dibiman ye i n’a fɔ Koka-Kola, o baga donna joli la, wa a bɛ joli kuru bilenmanw tiɲɛ (systemic viscerocutaneous loxoscelism / Coombs-negative hemolytic anemia), o de ka kan teliya la Denmisɛnw walima balikuw ka don ICU la walasa ka jidon jugumanba sɔrɔ jolisira fɛ ani jolidon dɛmɛni kama.

Desizɔn jiri : wuluw ka kinni ni MRSA kurukuruni ani neurotoxic vs cytotoxic triage¶

flowchart TD
    A["Siga bɛ a la ko wulu ka kinni walima fari joginda dimi"] --> B{"Yala i y’a ye ko wulu dɔ ye fari kin a kɛ waati min na wa?"}
    B -->|No spider seen; swollen painful red bump draining pus| C["CA-MRSA banakisɛw farikolojidɛsɛ sɔrɔli ka ca (80%)"]
    B -->|Yes, or classic clinical toxidrome developing| D{"A taamasiɲɛ minnu ka ca sanga 1 fo lɛri 24 kɔnɔ, olu ye jumɛnw ye?"}
    C --> E["Aw kana a sɔgɔsɔgɔ; trace dancɛ ni pen; aw bɛ taa dɔgɔtɔrɔso la walasa ka tigɛ ni jibɔ + MRSA banakisɛfagalanw"]
    D -->|Immediate pinprick, target halo with sweating/goosebumps, then severe muscle cramps in back, abdomen, or chest| F["Latrodectisme: Muso cɛ salen nɛrɛma walima Araignée rouge (alpha-latrotoxine) ."]
    D -->|Painless or mild sting initially; at 2 to 24 hr develops Red-White-and-Blue plaque with central pale blister| G["Loxoscelisme: Recluse brun / Araignée violine (sphingomyelinase D) ."]
    D -->|Australia eastern coast: large black spider, immediate severe pain, profuse sweating, drooling, muscle twitching| H["Australian Funnel-Web Spider: aw bɛ PIB kɛ joona + aw bɛ 000 wele Funnel-Web Antivenom kama"]
    F --> I["Aw bɛ aw ko ni safinɛ ni ji ye; aw bɛ jisuma pake sirilen kɛ a la; Aw kana PIB kɛ abada; taa ED la"]
    I --> J["Dɔgɔtɔrɔso ED : Opioïdes IV + bɛnzodiazepines + Equine Latrodectus Antivenom dimi jugumanba walima tansiyɔn jiginni na"]
    G --> K["Aw bɛ aw ko dɔɔni dɔɔni; nɛnɛma-komɛsi; ka bolokɔni kɔrɔta; Aw kana funteni, PIB, walima opereli daminɛ joona kɛ a la abada"]
    K --> L{"Sumaya, kurukuru, jaŋaniya, sugunɛ jɛman, walima den?"}
    L -->|Yes: Systemic Viscerocutaneous Loxoscelism| M["ICU donni teliya la: IV ji, ɛmoɲini/hémolyse laboratuwari minnu bɛ tugu ɲɔgɔn na, RBC donli"]
    L -->|No: Cutaneous Loxoscelism only| N["Sigida la joginda ladonni, tetanɔsi kurayali, sɔgɔsɔgɔninjɛ bilali kɔfɛ dɔrɔn eschar dantigɛli kɔfɛ dɔgɔkun 6 fo dɔgɔkun 8 kɔnɔ"]

Kɛnɛyasow ka ɲɔgɔn sangali kunkolo ni kun: Muso cɛ salen nɛrɛma (Latrodectisme) ni Recluse brun (Loxoscelisme) ni MRSA Abscess¶

Ikomi layidu talenw ni furakɛli fɔlɔ dɔgɔtɔrɔw bɛ to ka musocɛ salenw ka kinni minnu bɛ kɛ ni farikolojidɛsɛ ye, musocɛ salenw ka kinni minnu bɛ kɛ ni farikolojidɛsɛ ye, ani banakisɛw ka tobi minnu bɛ sɔrɔ tuma caman na, olu ɲagami ɲɔgɔn na, danfara min bɛ kɛ kɛrɛfɛ, o nafa ka bon kosɛbɛ:

Muso nɛrɛma ni wuluwulu bilenmanw (Latrodectus) ani Latrodectism neurotoxic¶

Alpha-Latrotoxin ka banakisɛfagalanw molekiyɔmu¶

Muso cɛ salen wuluw (Latrodectus mactans [Saheliyanfan musocɛ salen], Latrodectus hesperus [Tilebinyanfan musocɛ salen], Latrodectus variolus [Woroduguyanfan musocɛ salen], Latrodectus tredecimguttatus [Mɛditerane nɛrɛma musocɛ salen], ani Latrodectus hasselti [Ɔsitarali Redback]) bɛ ni baga glandes ni chitinous fangs dingɛw ye minnu ka jan fo ka se ka don hadamaden farikolo la (k’a sɔrɔ muso cɛ salen wulu misɛnninw tɛ se ka hadamaden fari sɔgɔ).

1. Presynaptic Calcium Pore Formation: Vertebrate neurotoxin principal min bɛ Latrodectus baga la, o ye alpha-latrotoxin ye, o ye 130-kDa proteine ye min bɛ taa ni lymphatic channels ye ka don systemic circulation kɔnɔ, ka siri ni affinity belebele ye neurexin ani latrophilin-1 receptors la presynaptic membrane of motor endplates ani autonome nɛrɛmuguma yɔrɔw.
2. Uncontrolled Neurotransmitter Dumping: Ni u sirilen don, alfa-latrotoxin molecule naani bɛ lajɛ ka kɛ tetramer ye ka don nerve terminal lipid bilayer kɔnɔ, ka kɛ calcium-permeable cation channel ye min bɛ to senna. Kalisiyɔmu ion minnu bɛ bɔ selilɛri kɔkan, olu bɛ woyo ka don presynaptic nerve terminal kɔnɔ, o bɛ kɛ sababu ye ka exocytose massive kɛ sinaptic vesicles la minnu kɔnɔ acetylcholine (kolo sɔgɔsɔgɔninjɛw ni ɲɔgɔn cɛ) ani norepinephrine ni epinephrine (sympathetic autonomic terminals) bɛ minnu na.
3. Tetaniki sɔgɔsɔgɔninjɛ minnu bɛ i n’a fɔ jikuruw, ni farikolojidɛsɛ saya banbali tɛ: A tɛ i n’a fɔ botulinum toxin, alpha-latrotoxin tɛ motɛri axon tiɲɛ kudayi. O nɔ na, ​​asetilikolini filili bɛ kolotugudaw datugu tetaniki, kirinni kirinni kɔnɔ ka sɔrɔ norepinefirini filili min bɛ kɛ ni hinɛ ye, o bɛ kɛ sababu ye ka sumaya caman kɛ sigida la, piloerekisini, ani tansiyɔn jiginni jugumanba, o bɛ dɔgɔya ka tɛmɛ lɛrɛ 48 fo lɛri 96 kan ni joli kuruw bɛ segin ka kɛ fɛn wɛrɛ ye.

Latrodectisme ka kɛnɛyako ɲɛtaa dɔnni¶

1. Fase 1: The Pinprick and Target Halo (0 fo 30 Minutes): A tɛ i n’a fɔ recluse bites, musocɛ salenw ka kinni kɛbagaw kɛmɛsarada la 75 fo 90 bɛ kinni in dɔn a kɛra yɔrɔnin kelen, a ka c’a la, pinprick nɔgɔlen don ni u bɛ ganw walima butiki don, ni u bɛ tasumamugu kɔrɔta, walima ni u bɛ se kɛnɛma minɛnw jukɔrɔ. Miniti 15 fo miniti 30 kɔnɔ, kinni bɛ kɛ yɔrɔ finman ye min bɛ kɛ bulama ye min lamininen don ni halo bilenman finman ye, ni sumaya misɛnninw ni gosi wulilenw ye kinni yɔrɔ yɛrɛ la.
2. Taabolo 2nan : Lamini jiginni ni sigida farikolojidɛsɛ (Miniti 30 ka se 90 ma): Sigida lamini ɲɛgɛnɛsira minnu bɛ kɔkolo walima kɔkili la, olu bɛ kɛ nɛrɛmuguma ye, ani farikolojidɛsɛ yelenw ni kirinni jugumanw, minnu bɛ i n’a fɔ vise, olu bɛ wuli ka wuli bolokɔni kinnilen kan ka taa a fan fɛ.
3. Fase 3 : Latrodectisme général, Kɔnɔbara min bɛ i n’a fɔ pankurun, ani Latrodectus Facies (Lɛrɛ 1 fo 12):
4. Kɔnɔbara duguma kinni bɛ yeelen bɔ cɛya la, kɔkolo kɔkolo la, ani kɔnɔbara ɲɛfɛla kogo la, ka kɔnɔbara basigilen farikolow datugu ka kɛ kɔrɔnfɛla ye min bɛ i n’a fɔ pankurun ni kirinni 10/10 ye minnu bɛ mɔgɔ tɔɔrɔ.
5. Sanfɛla walima kɔ kinni bɛ yeelen bɔ sɔgɔsɔgɔninjɛ la, kɔkolo cɛmancɛ farikolo yɔrɔw la, ani disi kogo la, o bɛ kɛ sababu ye ka disi gɛlɛya kosɛbɛ ani ka ninakilidegun min bɛ dusukun tantanni ladege.
6. Autonomic Triad and Restlessness: Bizarrement patterned sweating (diaphoresis), artériel hypertension severe (a ka ca a la a bɛ tɛmɛ 180/110 mmHg kan), ani Latrodectus facies (ɲɛda min bɛ bilen, a ɲɛji bɛ kɛ ni ɲɛda fununen ye ani ɲɛda sumaya). A tɛ i n’a fɔ banabagatɔ min bɛ ni opereli kɔnɔbaralabana lakika ye (apendise karilen) min bɛ da a ma lamaga a ka sɔgɔlilan kan, banabagatɔ min ye musocɛ salen nɛrɛma ye, o bɛ to ka a kɔkiliw wuli, ka taama, ka u kɔkiliw kɔrɔta k’a ɲini ka farikolojidɛsɛbanakisɛw kɔrɔta.

Dɔgɔtɔrɔso ɲɛnabɔli min bɛ musocɛ salen nɛrɛma ni muso bilenmanw ka baga kan¶

1. Mun na kalisiyɔmu glukonati min bɛ kɛ joli la, o tɛ baara kɛ tuguni: Kɛnɛyaso minnu kɔlɔsira, olu y’a jira ko Gluconate de calcium IV tɛ nafa sɔrɔ ni i ye a suma ni opioïde minnu bɛ kɛ joli la ni bɛnzoyazepiniw faralen don ɲɔgɔn kan.
2. Furakɛcogo fɔlɔ (Opioïdes IV + Benzodiazepines IV): Aw bɛ mɔrini IV titrated (0,1 mg/kg) walima IV fentanyl (1 mcg/kg) di dimi jugumanba la, ka fara IV benzodiazepine kan i n’a fɔ diazepam (5 fo 10 mg IV) walima lorazepam (miligaramu 1 fo miligaramu 2 IV) walasa ka kɔkolo GABA-A balili sabati, ka tetaniki farikolo tasuma lafiya, ani ka tansiyɔn jiginni kunbɛn.
3. Fura dafalen : Sow Latrodectus Banakisɛfagalan: Ameriki Woroduguyanfan na (Antivenin Latrodectus mactans) ani Ɔsitarali (CSL Redback Spider Antivenom), Sow ka banakisɛfagalan fiyɛlilan 1 fo 2 ni u pikirila miniti 15 fo miniti 30 kɔnɔ o bɛ farikolodimi ni tansiyɔn jiginni furakɛ pewu, min bɛ mɔgɔ tɔɔrɔ miniti 30 fo 60 kɔnɔ miniti. A jiralen don dimi jugumanba la min tɛ opioïde ni bɛnzoyazepiniw kɛlɛ, tansiyɔn jiginni gɛlɛya, kɔnɔmaya (walasa ka jiginni joona walima denso tiɲɛni bali), ani baga jugumanba denmisɛn fitininw walima baliku kɔrɔba barikamaw la.

Brown Recluse ani Violin Spiders (Loxosceles) ani Loxoscelisme Necrotique walima Sistémique¶

Ka ban ka sɔgɔsɔgɔninjɛ nkalonmaw kin: the NOT RECLUSE Mnemonic¶

Dɔgɔtɔrɔw ka teli ka banakisɛw CA-MRSA kurukuruw, sukarodunbana, herpes simplex, walima Lyme erythema migrans sɛgɛsɛgɛ cogo jugu la ni Brown Recluse bɛ kinni kɛ yɔrɔw la, Loxosceles wuluw tɛ sigiyɔrɔ minnu na. Toxicologistw bɛ baara kɛ ni NOT RECLUSE hakilijagabɔlan ye min sɛgɛsɛgɛra walasa ka recluse kinni bɔ kɛnɛ kan ani ka banakisɛfagalan dɔ dɔn:

• N (A ka ca): Brown Recluse kinni lakikaw 90% ni kɔ ye joginda kelen ye min bɛ kɛ a kelen na (ka bɔ wulu kelen min sirilen bɛ ka wuli dilan kan walima ka fini don). Joginda caman bɛ a jira ko wuluw, wuluwuluw, walima MRSA tobiw, a tɛ kɛ yɔrɔ ye min bɛ a yɛrɛ mabɔ.
• O (A kɛli): Ameriki Woroduguyanfan na, Loxosceles reclusa bɛ bɔ Amerika Saheli-Cɛmancɛ ni cɛmancɛ-tlebi dɔrɔn (Nebraska ni Iowa ka jigin fo Texas, kɔrɔn fɛ ka taa Georgia tilebin fɛ ani Ohio saheliyanfan fɛ). Loxosceles yɔrɔ minnu bɛ sɔrɔ yɔrɔ wɛrɛw la (walima Ameriki saheliyanfan fɛ L. laeta) kɔkan, mɔgɔ kelen-kelen bɛɛ ka kinni tɛ se ka kɛ.
• T (Waati): Loxosceles reclusa kinni minnu sɛgɛsɛgɛra, olu 85% ni kɔ bɛ kɛ kalo funtenimanw na (Awirilikalo fo Ɔkutɔburukalo).
• R (Centre rouge): Brown Recluse kinni lakika bɛ santiri ischemic pale, blanched, walima dark blue-purple sɔrɔ (barisa sphingomyelinase D bɛ kuru farikolojidɛsɛw la). Joginda min bɛ ni bilen jɛman, cɛmancɛ funteni ye banakisɛfagalan ye.
• E (Elevated Dome): Brown Recluse kinni lakika ye a fla ye walima a bɛ jigin a lamini fari jukɔrɔ (a janya bɛ se santimɛtɛrɛ 1 ma). Dome kɔrɔtalen, fununen min janya bɛ tɛmɛ santimɛtɛrɛ 1 kan o ye banakisɛfagalan ye min falen don nɔgɔ la (tobili).
• C (A bɛ mɛn kalo 3 kɔnɔ): Hali ni kirinni belebele minnu bɛ kɛ ni fɛnɲɛnamafagalan ye, olu bɛ kɛnɛya dɔgɔkun 8 fo dɔgɔkun 12 kɔnɔ. Joginda minnu bɛ to kalo 3 tɛmɛnen kɔ, olu ka kan ka biyɔpisi kɛ farikolo kansɛri, piyoderme gangrenosum, walima ɲɛgɛnɛsiralabanaw la.
• L (A ka bon santimɛtɛrɛ 10 ni kɔ): Joginda minnu bɛ u yɛrɛ la, olu 90% ni kɔ ka dɔgɔn ni santimɛtɛrɛ 3 fo 10 ye (santimɛtɛrɛ 1,2 fo santimɛtɛrɛ 4).
• U (Ulcerates Too Early, under 7 Days): Brown Recluse kinni lakika la, cɛmancɛ fari min bɛ wele ko ischemic, o bɛ kɛ ni sɔgɔsɔgɔninjɛ nɛrɛmuguma jalen ye (eschar) tile 5 fo 14 kɔnɔ ani a tɛ da wuli ka don crater ulcer kɔnɔ fo tile 7 fo tile 14. Joginda min bɛ pɛrɛn ka nɔgɔ jɛman jilama bɔ tile 2 walima tile 3 la, o ye banakisɛ MRSA tobili ye.
• S (Funa): N’a ma fɔ ɲɛkisɛ walima sen kan, kinni minnu bɛ kɛ yɔrɔ kelen na, olu tɛ kɛ sababu ye ka bolokɔni funuba kɛ ni gravitational erythema tɛ.
• E (Exudative Pus): Brown Recluse kinni lakikaw ye farikolo sɔgɔsɔgɔninjɛ jalenw ye. Nɔgɔ jɛman walima nɛrɛmuguma jɛman kɔrɔ ye banakisɛfagalanw ye, a tɛ kɛ wuluwulu baga ye.

Farikolo loxoscelisme ka banakɔtaa: Bilen, fin ani bulu ani girinya jɛnsɛnni¶

Ni Loxosceles wulu digilen don fari la fini walima dilan kɔnɔ, a dawolo bɛ sphingomyelinase D (phospholipase D) pikiri kɛ ka fara hyaluronidase kan:

1. Lɛrɛ 6 ka se 48 ma (Taamaʃyɛn bilenman, finman ani bulu):
2. Blue/Purple Center: Sphingomyelinase D bɛ endothéliale sphingomyeline tigɛ, ka joli segin furakisɛw fara ɲɔgɔn kan, ka neutrophils recruitment, ani microvascular thrombose bila sen kan. Joli bɔli kɔngɔ fɛ, cɛmancɛ ɲɛda bɛ kɛ violaceous blue-grey walima dark purple (a ka ca a la joli bɛ bɔ a la).
3. Cɛmancɛ bolokɔni finman: Ischemic core violet lamini na, bololanɛgɛ blanche pale dɔ bɛ yen min bɛ sɔrɔ reflex vasoconstriction fɛ.
4. Kɛnɛma-halo bilenman: Bolo finman lamini na, halo belebeleba dɔ bɛ yen min ye furu joli-sira-funu-banakisɛ (erythematous vasodilatory inflammation) ye.
5. Gravitational Downward Spread and Eschar Sloughing (Tile 5 ka se 21 ma): Ikomi Loxosceles baga bɛ hyaluronidase (spreading factor) sɔrɔ, girinya bɛ anzimu sama ka jigin ka tɛmɛ farikolo jukɔrɔ tulumafɛnw fɛ ka kɛ ɲɛjibɔ cogo ye. Kisɛ kɛmɛsarada la 10 fo 30 la minnu bɛ kɛ nekɔrɔsi ye (kɛrɛnkɛrɛnnenya la tuluma yɔrɔw kan i n’a fɔ cɛya, kɔkili walima kɔnɔbara), cɛmancɛ bulu bɛ gɛlɛya ka kɛ eschar ye min bɛ jigin, ka ja, nɛrɛmuguma ye tile 5 fo tile 7, o bɛ danfara don Tile 7 ni tile 21 cɛ, ka kirinni juguman to min bɛ kɛnɛya dɔgɔkun 4 fo dɔgɔkun 12 kɔnɔ.

Loxoscelisme viscérocutané systémique (Hémolyse intravasculaire: Ɲɛnamaya farati lakika) .¶

Ameriki Woroduguyanfan Loxosceles reclusa kinni kɛmɛsarada la 1 fo 2 (ani Ameriki saheliyanfan Loxosceles laeta kinni kɛmɛsarada la 10 fo 15), kɛrɛnkɛrɛnnenya la denmisɛnw la, sphingomyelinase D bɛ don joli la ka siri jolikisɛ bilenmanw la minnu bɛ lamini:

• Fulminant Intravascular Hemolysis: Hali ni fari kinni bɛ i ko a ka dɔgɔn, sistɛmu sphingomyelinase D bɛ glycophorins bɔ joli kuru bilenmanw na ka complement baara, o bɛ kɛ sababu ye ka acute intravascular hemolysis kɛ lɛrɛ 24 fo 72 kɔnɔ kinni kɔfɛ.
• Fara taamasiɲɛ minnu ka kan ka kɔlɔsi sanga 72 fɔlɔ kɔnɔ:
• Sumaya, farigan, fɔɔnɔ, kolotugudaw dimi, ani kuru bilenman jɛnsɛnnen min bɛ daminɛ lɛri 12 fo lɛri 48 kinni kɔfɛ.
• Sugunɛ min ɲɛ ye bulama ye, min ɲɛ ye te ye, walima min ɲɛ ye kola ye (hemoglobinuria) ni joli kuru bilenmanw wulilen don, olu bɛ ɛmoɲini gansan bɔn joli la ani sugunɛ na, o bɛ kɛ sababu ye ka sɔgɔsɔgɔninjɛ jugumanba (AKI) bila mɔgɔ la.
• Hémoglobine (jolidɛsɛ) min bɛ bin teliya la, a bɛ kɛ jɛman ye, a bɛ kɛ ni dusukun tantanni ye, ani jaundice (ɲɛ jɛmanw) DIC kɛrɛfɛ.
• Dɔgɔtɔrɔso labɛncogo: Denmisɛn walima baliku o baliku ni farigan, kurukuru, walima sugunɛ dibi bɛ a la, ni a bɛ siga ko a ka kinni kɛra a yɛrɛ ma, o ka kan ka dɔgɔtɔrɔso don teliya la, ka joli jate kɛ ka tugu ɲɔgɔn na (hemoglobine sanga 6 o lɛri 6 fo lɛri 12, LDH, bilirubini indirect, haptoglobine, créatinine, ani sugunɛbilenni), a bɛ kɛ ni fanga ye IV cristalloïde hydration, ani jolikisɛ bilenmanw doncogo pakew walasa ka ɛmoɲini jigin ka tɛmɛ garamu 7 fo 8 kan dL kɔnɔ.

Kɔlɔsili surun min kɛra Ɔsitarali Funnel-Web Spiders (Atrax & Hadronyche) kan: PIB ka danfara¶

Ɔsitarali kɔrɔnfɛla walima saheliyanfan kɔgɔjida la (Sydney ani Great Dividing Range ka bɔ Queensland ka taa Tasmanie), ni nɛgɛ dumanba dɔ ka kinni ye min bɛ manamana (Atrax robustus walima Hadronyche suguya), o bɛ delta-atracotoxins pikiri kɛ, ka kɛ sababu ye ka yɛrɛmahɔrɔnya ni farikolo-ɲɛnajɛ-fɔɲɔba dɔ kɛ min bɛ mɔgɔ ka ɲɛnamaya bila farati la 10 kɔnɔ ka se Miniti 60 (dimi jugumanba bɛ kɛ yɔrɔ la, kɔkiliw bɛ kirin, kan bɛ kirin, ka sɔgɔsɔgɔ ni sumaya caman kɛ, tansiyɔn jiginni, fogonfogon la kirinni, ani ninakilidegun). A tɛ i n’a fɔ Redback/Widow walima Recluse wuluw, Ɔsitarali Funnel-Web (walima Mouse Spider) ka kinni BƐ SƆRƆ teliya la ka Pressure Immobilization Bandage (PIB) + rigid splint, ka a jɔ pewu, ani ka taa ni anpulu ye teliya la (000) CSL Funnel-Web Spider Antivenom kama.

Sigidaw ka kɔrɔtɔko nimɔrɔw ani baaradaw ka sariyaw¶

• Amerika ni Kanada: Aw bɛ 911 wele ni farikolo gɛlɛya jugumanba, disi/kɔnɔdimi, ninakili gɛlɛya, walima farikolo taamasiɲɛw. Aw bɛ US Poison Control wele telefɔni 1-800-222-1222 (walima Kanada mara baga furakɛli yɔrɔ dɔ) tile 24/7 walasa ka dɔgɔtɔrɔso baga dɔnbagaw ka laadilikan sɔrɔ Latrodectus banakisɛfagalan walima Loxosceles joli seginni kɔlɔsili kan.
• Ɔsitarali ani Zelande kura: Aw bɛ 000 wele Ɔsitarali walima 111 Nuwɛlika. Aw ye ANZCOR ka laadilikan 9.4.2 (Baga: Arajo ka kinni) labato:
• Ni Redback Spider (Latrodectus hasselti) walima jirisunba wɛrɛw ye: aw bɛ nɛnɛma-komɛsi (jikuru sirilen fo miniti 20) kɛ a la; aw kana Pressure Immobilisation Bandage kɛ a la. Aw bɛ dɔgɔtɔrɔso ladonni ɲini dimimadafura ni CSL Redback Antivenom la ni dimi ka jugu.
• Ni Big Black Spiders (Funnel-Web Atrax/Hadronyche walima Mouse Spider Missulena) ye: aw bɛ Pressure Immobilization Bandage (PIB) ni splint kɛ a la joona ka 000 wele.Aw bɛ Australian Poisons Information Center wele telefɔni 13 11 26 la.
• Royaume-Uni: Aw bɛ 999 wele ni kɔrɔtɔko don walima NHS 111 walasa ka kɛnɛyaso jateminɛ teliya la. A kɔlɔsi ko Black Widows lakikaw ni Brown Recluses si tɛ Angletɛri jamanaden ye; native Noble False Widow spiders (Steatoda nobilis) bɛ sigida dimi ni farigan misɛnni ("steatodism") lase mɔgɔ ma min bɛ i n’a fɔ wasp, ni u furakɛra ni safinɛ/ji ko ye, ni degun nɛnɛmanw ye, ani ni dimimadafura ye da kɔnɔ, ka sɔrɔ "spider bites" funu bilenman jugumanba Angletɛri jamana na, a bɛ se ka fɔ ko banakisɛfagalanw ka kan ka kɛ banakisɛfagalanw ye tuma bɛɛ.
• Erɔpu jamana ni Mediterane: Dial 112. Erɔpu Saheliyanfan na (Esipaɲi, Itali, Gɛrɛsi, Faransi Saheli, Balkan), Mɛditerane musocɛ nɛrɛma (Latrodectus tredecimguttatus) ani Mɛditerane Recluse (Loxosceles rufescens) fila bɛɛ ye jamanadenw ye aw bɛ taa dɔgɔtɔrɔso la kɔrɔtɔko yɔrɔ la min ka surun aw la ni farikolojidɛsɛ jugumanw walima farikolojidɛsɛbanakisɛw ye.
• Amerika saheliyanfan (Brezil, Peru, Sili, Arzantine) ani Afiriki tilebinyanfan: Aw bɛ 192 / 193 wele Berezil, 131 Sili, 106 Peru, walima 10177 / 112 Afiriki tilebinyanfan fɛ. Berezili ni Peru jamanaw na, yɔrɔ minnu na Loxosceles laeta ni Loxosceles intermedia barikamaw bɛ kɛ sababu ye ka joli-sira-funu (hémolyse systémique viscerocutanée) caya, soro anti-loxoscelic / anti-arachnid anti-loxoscelic (soro antiaracnídico / antiloxoscélico) bɛ mara kɛnɛya minisiriso dɔgɔtɔrɔsow fɛ, ka di 36 fɔlɔ kɔnɔ ka se lɛri 48 ma, loxoscelisme (loxoscelisme) hakɛ dantɛmɛnen fo ka se a jugumanba ma.

Ɲininkali minnu bɛ kɛ tuma caman na¶

Ne bɛ se ka danfara don cogo di Black Widow ka kinni ni Brown Recluse ka kinni cɛ?¶

U bɛ taamasiɲɛw bɔ minnu tɛ kelen ye pewu. Musocɛ nɛrɛma ka kinni bɛ kɛ i n’a fɔ pinɛ sɔgɔlen o yɔrɔnin bɛɛ, a bɛ se ka fɔ ko a tɛ fari tiɲɛni si to (bololanɛgɛ jɛman misɛnnin dɔ dɔrɔn min bɛ ni sumaya jikuruw ni gosiw ye minnu bɛ yɔrɔ kelen na), wa miniti 30 fo 90 kɔnɔ, a bɛ kɛ sababu ye ka farikolojidɛsɛ jugumanba lase mɔgɔ ma, min bɛ i n’a fɔ jikuruw cɛmancɛ la, kɔ duguma, disi la ani kɔnɔbara la (ka kɔnɔbara fasaw wuli ka gɛlɛya) ka fara joli caman kan degun ni sumaya. A ka ca a la, dimi tɛ kɛ ni Brown Recluse kinni ye a daminɛ na, a tɛ kɛ sababu ye ka farikolo gɛlɛya abada, wa lɛri 6 fo lɛri 48 ni kɔ, a bɛ kɛ sababu ye ka yɔrɔ dɔ la, fɛn bilenman, finman ani bulu laɲinilen dɔ bɛ sɔrɔ fari la min bɛ se ka wuli ka kɛ sɔgɔsɔgɔninjɛ nɛrɛmuguma jiginnen ye (eschar) ani kirinni min bɛ kɛnɛya dɔɔni dɔɔni.

Mun na "sɔgɔsɔgɔninjɛ kinni" bilenman minnu bɛ dimi, minnu funun, olu fanba ye MRSA banakisɛ faritanabanaw ye tiɲɛ na?¶

Fo n’i y’a ye tiɲɛ na ko wulu dɔ y’i kin a kɛ waati tigitigi la, sɛgɛsɛgɛli minnu kɛra kɛnɛyaso kɔrɔtɔlenw na, olu y’a jira ko joginda kɛmɛsarada la 80 ni kɔ banabagatɔw dalen b’a la ko wuluw ka kinni don, tiɲɛ na, olu ye farikolojidɛsɛ (boli) ye minnu bɛ sɔrɔ Staphylococcus aureus (MRSA) fɛ min tɛ se ka mɛtisilini kɛlɛ. Brown Recluse kinni lakika bɛ kɛ fla ye walima ka jigin ni cɛmancɛ bulu-bulu jɛman walima dibi ye ani farikolo yɔrɔ jalenw ka saya, k’a sɔrɔ joginda min bɛ kɔrɔta i n’a fɔ doni fununen, a cɛmancɛ la, a ka suma ani a bilennen jɛman, ka ji jɛman walima nɔgɔ finman bɔ tile damadɔ kɔnɔ, o ye banakisɛfagalan ye min mago bɛ furakɛli jibɔ ni banakisɛfagalanw na.

Mun na Black Widow wulu kinni bɛ i kɔnɔbara gɛlɛya i n’a fɔ jiribolo, i n’a fɔ ɲɛgɛnɛsira karilen?¶

Alpha-latrotoxin bɛ musocɛ nɛrɛma baga la, o ye farikolojidɛsɛ ye min bɛ taa sanfɛ ɲɛgɛnɛsiraw la ka bɔ sen walima sen kinni na, ka kalisiyɔmu sɔgɔsɔgɔninjɛw gosi ka don motɛri nɛrɛmuguma dakunw na minnu bɛ cɛya, kɔ duguma ani kɔnɔbara kogo farikolo belebelebaw di. Ni farikolojidɛsɛbanakisɛ asetilikolini (cetylcholine) filili ka caya, o bɛ kɔnɔbara kogo farikolo yɔrɔw datugu ka kɛ tetaniki sɔgɔsɔgɔninjɛ ye min bɛ to senna, min tɛ kɛ a yɛrɛ sago la. Dɔgɔtɔrɔw b’a faranfasi ni kɔnɔbara basigilen ye barisa banabagatɔ lafiyabali don ani a bɛ kirin sanni a ka da a la, kɔnɔbara kɔnɔna seginni lakika tɛ yen, wa dimi bɛ ban joona ni opioidw, bɛnzoyazepiniw walima Latrodectus antivenom ye jolisira fɛ.

Yala ne ka kan ka jisuma walima funteni bila Brown Recluse walima Black Widow spider bite kan wa?¶

Aw bɛ baara kɛ tuma bɛɛ ni komɛsi nɛnɛman ye walima ni jisumamugu ye min sirilen don fini sanuman na (miniti 10 fo miniti 15 a waati kelen na), ani aw kana tasumamugu walima jisuma kɛ abada Brown Recluse kinni na min bɛ siga la. Anzimu min bɛ farikolo yɔrɔw tiɲɛ Brown Recluse baga la (sphingomyelinase D) o bɛ baara kɛ joona ni funteni ka bon; funteni kɛli bɛ fari fagali teliya, k’a sɔrɔ nɛnɛ nɔgɔman bɛ anzimu sumaya ani ka sigida dimi nɔgɔya Brown Recluse ni Black Widow kinni fila bɛɛ la.

Mun na a nafa ka bon ka den ka sugunɛ kulɛri lajɛ tile 3 kɔnɔ, siga bɛ a la ko Brown Recluse (Brown Recluse) kinni kɔfɛ?¶

Brown Recluse ka kinni kɛmɛsarada la 1 fo 10 la, ani ka kɛɲɛ ni a hakɛ ye denmisɛnw na, baga anzimu sphingomyelinase D bɛ don joli la ka bin joli kuru bilenmanw kɛnɛma yɔrɔw kan, o bɛ kɛ sababu ye u ka pɛrɛn joli siraw kɔnɔ (hémolyse intravasculaire systémique) lɛrɛ 24 ni 72 cɛ kinni kɔfɛ. Hali ni fari kinni bɛ i ko a ka dɔgɔn, joli kuru bilenman minnu bɛ pɛrɛn, olu bɛ sugunɛ kɛ bulama ye, ka kɛ nɔgɔ ye, walima ka kɛ kola ye (hemoglobinuria) ani o bɛ se ka kɛ sababu ye ka jolidɛsɛ ni sugunɛbilenni bila mɔgɔ la min bɛ se ka mɔgɔ ka ɲɛnamaya bila farati la, o min bɛ kɛ sababu ye ka farikolojidɛsɛ furakɛ joona ICU la ani ka joli don a la.

Yala aw ka kan ka don dɔ ka Pressure Immobilisation Bandage walima tourniquet sirilen dɔ siri Black Widow walima Brown Recluse bite la wa?¶

Ayi, aw kana tourniquet walima elastic Pressure Immobilisation Bandage kɛ abada musocɛ salen nɛrɛma, Redback walima Brown Recluse kinni na. Ni aw ye Brown Recluse baga minɛ yɔrɔ kelen na, o bɛ farikolo yɔrɔw labɔ anzimu (enzyme) caman kɛ ka farikolojidɛsɛ jugumanba bila mɔgɔ la, ka sɔrɔ ka Widow walima Redback kinni kɛ ni bandi ye, o bɛ sigida dimi juguya ka sɔrɔ a ma a kɔlɔlɔw ɲɛ. (Pressure Immobilization Bandages bɛ kɛ Ɔsitarali Funnel-Web wuluw ni sa bagalenw na, abada Widow walima Recluse wuluw kama.)

Sosow ani ɲɛmɔgɔyaso ka bilasiralikan¶

• Amerika ka baga kɛlɛli tɔnba (AAPCC) & Ameriki ka dɔgɔtɔrɔso toxicologie kalanso (ACMT, Etazuni): Dɔgɔtɔrɔso baarakɛcogo laadilikanw ani bagako lajɛw Latrodectus (muso cɛ salen) ni Loxosceles (Recluse) bagaw kan ani NOT RECLUSE Diagnostic Mnemonic (Vetter et al., JAMA Dermatology).
• Ɔsitarali lakununni tɔnba (ANZCOR, Ɔsitarali ani Zelande kura): ANZCOR ka laadilikan 9.4.2: Baga, arajo kinni (Redback Spider cold-pack protocol vs. Funnel-Web Spider Pressure Immobilization Bandage protocol).
• Banaw kɛlɛli ni u kunbɛnni baaradaw (CDC / NIOSH, Etazuni): Sankɛ bagalenw (Black Widow and Brown Recluse): U dɔnni, u dɛmɛni fɔlɔ, ani u furakɛli kɛnɛyaso la, ka fara u ni CA-MRSA faritanabanaw danfara kan.
• Diɲɛ kɛnɛyatɔn (OMS) & Pan Ameriki kɛnɛyatɔn (PAHO): Loxoscelisme (Syndromes hémolytiques cutanées et viscerocutanées) ani Latrodectisme furakɛli kɛnɛyaso la Ameriki jamanaw na.
• Jamana ka kɛnɛyako baarada (NHS, Angletɛri) & Jamana ka bagajiw kunnafonidiso (NPIS): Ara ka kinni: Dɛmɛ fɔlɔ, Steatoda (musocɛ salen nkalonma) furakɛli, ani banakisɛfagalanw ka darapo bilenmanw.

Gafe minnu bɛ tali kɛ o ko la¶

• Tiki ni sɔgɔsɔgɔninjɛ bɛ dɛmɛ fɔlɔ kɛ
• Selulɛti jɛnsɛnni, ɲɛgɛnɛsira bilenmanw, ani MRSA farikolojidɛsɛ
• Sa ka kinni ni fɛnɲɛnama bagalenw ka kɔrɔtɔko
• Sugunɛ joginni jugumanba, rabdomyolyse, ani sugunɛ dibi la
• Kɔrɔtɔko nimɔrɔw ka kɛɲɛ ni jamana ye