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    Black Widow Spider Envenomation with Elevated Troponin I Levels
    (Aves, 2018) Das, Murat; Akdur, Okhan; Akman, Canan; Cetinkaya, Yasemin
    Introduction: The black widow spider is found worldwide. Alpha-latrotoxin is responsible for the toxic effects related to the spider bite. We report the case of a patient who presented at the emergency department after being bitten by a black widow spider that later developed increased cardiac enzymes. Case Report: The patient was a 24-year-old male who had been bitten by a black spider inside his shoe while he was working in the garden. The patient was referred to the emergency department of department of emergency medicine Canakkale Onsekiz Mart University Faculty of Training and Research Hospital with nausea, vomiting, and severe rigidity in the abdomen for the differential diagnosis of acute abdomen. With severe sweating, the patient had rales in the lower lung zones, and abdominal examination revealed diffuse abdominal guarding. Blood biochemistry revealed creatine kinase (CK): 1838 U/L, CKMb: 71.6 U/L, and troponin I: 0.14 ng/mL. In follow-ups, the troponin I levels increased to 3.01 ng/mL. Electrocardiography revealed normal sinus rhythm. He was followed with a bedside monitor for 3 days in the emergency department. When the patient's troponin I and CK levels decreased, at the end of the third day he was discharged.. Conclusion: Black widow envenomation should be followed for cardiac toxicity other than symptoms, such as muscle spasms, sweating, anxiety, and headache.