Keywords
Loxoscelism
Hemolysis
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Abstract
Objective: To report a case of acute kidney injury (AKI) caused by spiderwort in the Amazon. Case Details: A 49-year-old man was bitten by a spider on his right elbow while wearing his professional uniform, in the Floresta area, in the municipality of Terra Santa. He developed local and systemic inflammatory signs and progressed to septic shock, respiratory failure, rhabdomyolysis, jaundice, anemia and Acute Kidney Injury. He was transferred to the municipality of Santarém, 202 km as the crow flies from the site of the bite, to receive intensive care, ventilatory support, noradrenaline, use of antibiotics (Ceftriaxone, Clindamycin, then Piperacillin-Tazobactam and Vancomycin), antiarachnid serum, transfusions blood and hemodialysis. After hemodynamic stabilization, extubation, infection control and slow improvement in renal function, he was transferred from the ICU to the ward on the 11th day of hospital stay. He was then discharged from hospital for outpatient follow-up, without the need for hemodialysis. Final Considerations: The importance of early diagnosis measures and adequate treatment of ARF, especially dialysis, is concluded.
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