RobertoZG

Emergency Medicine

A 14-year-old female who was taken to the emergency room by her parents for presenting a lesion on her right hand located on the thumb, with fever, myalgia and general malaise. When questioned, the minor reported that upon waking up (3 days prior to her admission to the emergency room) she felt slight numbness in her right thumb with an unspecific reddish spot, which later yesterday morning was surrounded by a whitish halo (no images) and the day she went to the emergency room she woke up with the lesion shown in the images with worsening of general symptoms.

Suspecting a spider bite, the parents were asked to look in the child's room for the presumed culprit, who was found behind the bed, captured and taken to the hospital (later I myself relocated her to an out-of-risk place without harming her). Vital signs, except temperature, normal. Physical examination with fever of 38.5 °C, localized pain, generalized myalgias. Laboratory studies with grade I anemia and slight elevation of bilirubin, rest normal.

Corticosteroids and dapsone were administered with adequate response, he presented good evolution during his hospital stay and medical discharge was decided. What is the presumptive diagnosis and the culprit? I read them.

Update 1

Appropriate follow-up of the injury was performed with good results and adequate recovery.

Diagnosis Added

CUTANEOUS-VISCERAL LOXOSCELISM

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