medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-021medsovet-9006Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYУкус сколопендры в Крыму (клиническое наблюдение)Scolopendra bite in Crimea (clinical observation)https://orcid.org/0009-0000-3799-3059ЮрьеваС. В.YurievaS. V.

Юрьева Светлана Владимировна - к.м.н., доцент Института семейной медицины.

163069, Архангельск, Троицкий проспект, д. 51

Svetlana V. Yurieva - Cand. Sci. (Med.), Associate Professor of the Institute of Family Medicine.

51, Troitskiy Ave., Arkhangelsk, 163069

silviya5@yandex.ruhttps://orcid.org/0000-0002-4089-8340ДиденкоГ. В.DidenkoG. V.

Диденко Георгий Витальевич - студент лечебного факультета.

163069, Архангельск, Троицкий проспект, д. 51

Georgiy V. Didenko - Student of the Faculty of Medicine.

51, Troitskiy Ave., Arkhangelsk, 163069

didenko.georgij@yandex.ruhttps://orcid.org/0009-0007-8855-1323МолоковаЭ. Ю.MolokovaE. Yu.

Молокова Элина Юрьевна - студент лечебного факультета.

163069, Архангельск, Троицкий проспект, д. 51

Elina Yu. Molokova - Student of the Faculty of Medicine.

51, Troitskiy Ave., Arkhangelsk, 163069

elly.mol@mail.ruhttps://orcid.org/0009-0007-7754-4267СултановаД. М.SultanovaD. M.

Султанова Диана Магомед-Мирзаевна - студент лечебного факультета.

163069, Архангельск, Троицкий проспект, д. 51

Diana M. Sultanova - Student of the Faculty of Medicine.

51, Troitskiy Ave., Arkhangelsk, 163069

diana_sultanova@mail.ruhttps://orcid.org/0009-0001-6954-5362КолбасенкоА. С.KolbasenkoA. S.

Колбасенко Александра Сергеевна - студент лечебного факультета.

163069, Архангельск, Троицкий проспект, д. 51

Aleksandra S. Kolbasenko - Student of the Faculty of Medicine.

51, Troitskiy Ave., Arkhangelsk, 163069

kolbasenko.01@mail.ruhttps://orcid.org/0009-0003-5293-2168ЛапшинаА. В.LapshinaA. V.

Лапшина Анна Васильевна - участковый врач-терапевт, врач приемного покоя.

169711, Республика Коми, Усинск, Больничный проезд, д. 2

Anna V. Lapshina - District Therapist, Emergency Room Doctor.

2, Bolnichnyi Proezd, Usinsk, Komi Republic, 169711

anna_lapshina2000@mail.ruhttps://orcid.org/0009-0001-5955-1195ЮрьеваА. И.YurevaA. I.

Юрьева Анастасия Ильинична - студент лечебного факультета.

127473, Москва, ул. Делегатская, д. 20, стр. 1

Anastasia I. Yureva - Student of the Faculty of Medicine.

20, Bldg. 1, Delegatskaya St., Moscow, 127473

nastyaurieva02022006@gmail.comСеверный государственный медицинский университетРоссияNorthern State Medical UniversityRussian FederationУсинская центральная районная больницаРоссияUsinsk Central District HospitalRussian FederationРоссийский университет медицины (РосУниМед)РоссияRussian University of Medicine (ROSUNIMED)Russian Federation20251204202503128133Copyright © Юрьева С.В., Диденко Г.В., Молокова Э.Ю., Султанова Д.М., Колбасенко А.С., Лапшина А.В., Юрьева А.И., 20252025Юрьева С.В., Диденко Г.В., Молокова Э.Ю., Султанова Д.М., Колбасенко А.С., Лапшина А.В., Юрьева А.И.Yurieva S.V., Didenko G.V., Molokova E.Y., Sultanova D.M., Kolbasenko A.S., Lapshina A.V., Yureva A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9006

Сколопендры представляют собой наиболее известный род многоножек. Это самые крупные многоножки. Во всем мире было зарегистрировано несколько случаев отравления ядом сколопендр. Нами представлен клинический случай необычной реакции на укус сколопендры в Крыму с тяжелыми острыми неврологическими и суставными проявлениями и трудно диагностируемыми отдаленными осложнениями, где, несмотря на весь спектр оказанной медицинской помощи и активную тактику ведения, у пациентки из-за индивидуальных особенностей иммунитета, в том числе генетически обусловленных вследствие наличия раннее не диагностированной дисплазии соединительной ткани, развились аллергическая, а впоследствии и аутоиммунная патологии. На основании ретроспективного наблюдения было показано, как имеющийся у пациентки врожденный дисбаланс в клеточном и гуморальном звеньях иммунитета поспособствовал развитию более отягощенной клинической картины на укус членистоногого, а непосредственно его яд выступил первоначально в качестве аллергического, а впоследствии аутоиммунного триггера. Был проведен обзор современной российской и зарубежной литературы о случаях укусов сколопендры, где демонстрируются возможные осложнения, связанные с действием яда. Даны рекомендации врачам первичного звена по тактике ведения подобных пациентов.

Scolopendrae represent the best-known genus of centipedes. They are the largest centipedes. There were several reported cases of scolopendra venom poisoning around the world. We report a clinical case of an unusual reaction to a scolopendra bite in Crimea, accompanied by severe acute neurological and articular manifestations and hard-to-diagnose delayed sequela. Despite the full range of medical care provided and active management strategy, the female patient developed allergic and subsequently autoimmune pathologies due to individual immune characteristics, including genetic ones caused by the presence of previously undiagnosed connective tissue dysplasia. The retrospective observation showed how the female patient’s congenital imbalance between humoral and cellular components of the immune system contributed to the more aggravated clinical picture that developed as reaction to the arthropod bite, and it was its venom that initially acted as an allergic, and subsequently as an autoimmune trigger. A review of modern Russian and foreign literature on cases of scolopendra bites was performed. This review highlighted possible complications associated with the effects of the venom. Recommendations on the management strategies for such patients are provided to primary care physicians.

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The authors declare that there are no conflicts of interest present.