Case reports

Guam
Fritts et al. 1990: 4 bites in children. Identification: geographical exclusion.

Signs & symptoms

Local effects

Local swelling with skin discolouration and blistering 3/4, local swelling without skin discolouration or blistering 1/4, necroses 0/4 (Fritts et al. 1990). 

Neurological effects

Ptosis 2/4, muscle weakness in the extremities 1/4, spastic movements of the extremities 1/4, respiratory problems 2/4, whereby one child suffered respiratory arrest (in one child, the treating doctor did not exclude an anaphylactoid cause of the serious course of the envenoming with respiratory arrest) (Fritts et al. 1990). In animal experiments (mice), a myotoxic effect of the poison was observed, with multifocal degeneration and necrosis of the muscle fibers, as well as myoglobinuria (Weinstein et al. 1991). 

Case fatality rate

0/4 (Fritts et al. 1990).

Treatment (symptomatic)

Artificial respiration.

Treatment (specific)

Antivenom: no antivenom available.