Bitten by Poecilotheria metallica, 藍寶石華麗雨林

 

Substance (物質)

Poecilotheria metallica

Toxin Type: Venom (神經毒性為主，可能帶有少量細胞毒性成分)

 

Common Name (俗名)

藍寶石華麗雨林

 

Involving System (受影響的系統)

神經系統 (Nervous System): 主要受到毒液中神經毒素影響，導致疼痛及神經異常症狀 [1]

肌肉骨骼系統 (Musculoskeletal System): 咬傷部位可能有肌肉痙攣和強烈疼痛[1]

皮膚及軟組織 (Skin and Soft Tissue): 局部紅腫、疼痛，偶爾出現壞死 [2]

extensive muscle damage on day 5. However, by day 10, the regeneration was evident, and the regeneration process continued until day 20.[3]

 

Presentation (臨床表現)

局部症狀:

-          強烈的刺痛或灼熱感 [2] 紅腫及輕微出血 [2]

在部分病例中，可能有壞死或局部潰瘍

全身症狀:

肌肉痙攣 [1] 神經麻木或刺麻感 [1]

偶爾伴隨頭痛、噁心

心悸或呼吸困難 (罕見，但需密切觀察)

 

Antidote (解毒劑)

目前無特定解毒劑 (No specific antidote available) [2]

對症治療:

局部清創及止痛藥 (如NSAIDs)

抗組胺藥物 (如必要，用於減少局部腫脹和過敏反應)

嚴重情況下可考慮短期使用皮質類固醇

-          atropine, chloropyramine, chlorpromazine, diazepam, ethanol, flupirtine, haloperidol, ketotifen, lamotrigine, oxcarbazepine, tolperisone, xylazine, and CaCl2, helpful to suppress the envenomation symptoms [1] and [4]

 

Disposition (處置建議)

 

-          Poecilotheria fasciata venom effects were studied in detail at a sub-lethal dose of 5 mg/kg (LD50 = 12 mg/kg). [1]

輕症患者 (Mild Cases):

局部清潔傷口並冰敷

使用止痛藥進行緩解

居家觀察，特別注意有無全身症狀發展

 

中重症患者 (Moderate to Severe Cases):

入院觀察 24-48 小時

密切監測神經系統及心肺功能

必要時進行支持性治療 (如氧氣給予或肌肉鬆弛劑) [1]

-          No fatal cases reported so far.  

 

感染風險:

若懷疑有細菌感染，根據感染症狀開始抗生素治療

-          Poecilotheria metallica 的咬傷案例相對少見，但與其他樹蛛類似，其毒液效力偏低，致命性極低。臨床管理以支持性治療和觀察為主，並防止繼發感染。

 

References

 

1.      Andreev-Andrievskiy A, Popova A, Lagereva E, Osipov D, Berkut A, Grishin E, Vassilevski A. Pharmacological analysis of Poecilotheria spider venoms in mice provides clues for human treatment. Toxicon. 2017 Nov;138:59-67. doi: 10.1016/j.toxicon.2017.08.013. Epub 2017 Aug 12. PMID: 28811247.

 

2.      José Alejandro GA, Juan M, Luis CB, Fátima Pamela SM, Ivonne B, Diana Laura PT, Ashly M. Envenomation by the Indian ornamental tarantula (Poecilotheria regalis): A case report on treatment with Latrodectus mactans antivenom. Toxicon. 2024 Aug 28;247:107842. doi: 10.1016/j.toxicon.2024.107842. Epub 2024 Jul 1. PMID: 38960287.

 

3.      Richards NJ, Alqallaf A, Mitchell RD, Parnell A, Haidar HB, Almeida JR, Williams J, Vijayakumar P, Balogun A, Matsakas A, Trim SA, Patel K, Vaiyapuri S. Indian Ornamental Tarantula (Poecilotheria regalis) Venom Affects Myoblast Function and Causes Skeletal Muscle Damage. Cells. 2023 Aug 15;12(16):2074. doi: 10.3390/cells12162074. PMID: 37626884; PMCID: PMC10453882.

 

4.      Ramesh R, Kanagasingam A, Anushanth U, Gunasinghe A, Suganthan N. A Case Report on Generalised Muscle Spasms After Ornamental Tarantula Bites That Responded Well to Intravenous Calcium Gluconate Treatment. Cureus. 2023 Aug 7;15(8):e43074. doi: 10.7759/cureus.43074. PMID: 37692640; PMCID: PMC10483889.

 

Edited by Yu-Jang Su Dec 3, 2024.