A loxoscelism case received therapeutic apheresis and hyperbaric oxygen therapy

Abstract

Loxosceles reclusa (L.reclusa) is known to bite humans, and its venom includes several enzymes that cause clinical symptoms. Loxoscelism, a condition due to being bitten by Loxosceles spiders, commonly known as recluses, can involve a range of clinical conditions, from local cutaneous lesions to severe systemic involvement. The diagnosis of loxoscelism is usually made by anamnesis, and clinical findings. Magnetic resonance imaging is recommended for patients at high risk of necrotizing fasciitis. Treatment modalities are still controversial and there is no standardized treatment approach. Reported here, our case of loxoscelism involved a 24-year-old man presenting with a Loxosceles spider bite, dermonecrotic lesion, vomiting, diarrhea, acute renal injury, and rhabdomyolysis, who was successfully treated with hyperbaric oxygen therapy, therapeutic apheresis, hemodialysis, wound debridement, and cutaneous autografting. Early diagnosis and multidisciplinary approach can be life-saving in spider bites that can cause systemic involvement. Loxoscelism should be considered in patients with skin necrosis, acute renal injury, and rhabdomyolysis.

Spiders in Brazil: from arachnidism to potential therapeutic use of their venom part 2 of 2

“…For moderate injuries, Lopes et al (2020) believe that the use of analgesics, antibiotics (if there is secondary infection) and, in some cases, dapsone, especially in severe injuries, is indicated. Hyperbaric oxygen therapy and surgical treatment may be necessary in some cases (Swanson & Vetter, 2006;Cetinkaya et al, 2020). Skin lesions are not, as a rule, prevented by the use of serotherapy (Lopes et al, 2020).…”