Background Rhabdomyolysis after spider bite has been reported in a small number of patients, and myocarditis in even fewer. However, arrhythmia associated with latrodectism in children has not been described in the literature to date. Case summary A girl presented approximately 4.5 h after being bitten on the left ankle by a black spider. Two unifocal premature ventricular contractions (PVCs) were observed on the electrocardiogram. In laboratory tests, creatine kinase was elevated. On day 2, levels of troponin, pro-brain and natriuretic peptide were elevated. Electrocardiogram revealed inverted and biphasic T waves. Echocardiography revealed mild left ventricular dilation, mitral and aortic valve regurgitation. Holter electrocardiogram showed PVCs. Her laboratory and echocardiography findings completely normalized after discharge, and no arrhythmia was observed on the Holter electrocardiogram during outpatient follow-up. Conclusion Although spider bites are uncommon, they can cause serious systemic effects. These patients should be evaluated for arrhythmia, rhabdomyolysis and myocarditis.

中文翻译：

---

蜘蛛咬伤后横纹肌溶解、心肌炎和心律失常并存：一例报告

背景 蜘蛛咬伤后横纹肌溶解症的报道很少见，而心肌炎的报道更少。然而，迄今为止，文献中尚未描述与儿童 latrodectism 相关的心律失常。病例总结 一名女孩左脚踝被黑蜘蛛咬伤约 4.5 小时后就诊。在心电图上观察到两次单灶性室性早搏 (PVC)。在实验室测试中，肌酸激酶升高。第 2 天，肌钙蛋白、前脑和利钠肽水平升高。心电图显示倒置和双相 T 波。超声心动图显示轻度左心室扩张、二尖瓣和主动脉瓣关闭不全。动态心电图显示 PVC。出院后，她的实验室和超声心动图检查结果完全恢复正常，门诊随访Holter心电图未见心律失常。结论 虽然蜘蛛咬伤并不常见，但它们会引起严重的全身性影响。应对这些患者进行心律失常、横纹肌溶解症和心肌炎的评估。