Acute kidney injury and dermonecrosis after Loxosceles reclusa envenomation

Nag, Arijit; Datta, Joydip; Das, Arindam; Agarwal, Anil; Sinha, Debanjali; Mondal, Samim Ali; Ete, Tony; Chakraborty, Atanu; Ghosh, Sujoy

doi:10.4103/0971-4065.133017

Cited by 14 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…AKI was only observed in 3 of 9 patients (33.3%) with an average rise in serum creatinine of 1.03 from baseline. Hemolysis, direct toxin-induced acute tubular necrosis, rhabdomyolysis, and hypoperfusion from sepsis have been postulated as the cause of kidney injury in loxoscelism [11]. In our review, AKI did not correlate with the severity of hemolysis or sepsis and resolved after fluid and steroid administration.…”

Section: Discussionmentioning

confidence: 63%

Loxoscelism: Cutaneous and Hematologic Manifestations

Nguyen

Pandey

2019

Advances in Hematology

View full text Add to dashboard Cite

Background. Brown recluse spider (BRS) envenomation can lead to significant morbidity through severe local reaction and systemic illness including acute hemolytic anemia, rhabdomyolysis, disseminated intravascular coagulopathy (DIC), and even death. We aim to describe the clinical features and the roles of antibiotics and steroids in the treatment of loxoscelism. Methods. We retrospectively identified nine patients (pts) at our institution who were admitted with moderate to severe loxoscelism. A chart review was performed to highlight important clinical features and effect of interventions. Results. Nine pts (age 18 to 53) presented with fever (6), rash (9), pain/swelling (4), and jaundice (2). Of these, 6 pts had antecedent spider bites documented. Five pts were discharged from Emergency Room (ER) with oral antibiotics for “cellulitis” and were readmitted with severe systemic symptoms, with almost half (45%) of the pts being admitted to the intensive care unit. The most common admission diagnosis was sepsis secondary to cellulitis (6). Four pts developed worsening dermonecrosis, and 3 received prompt incision and drainage (I&D) with debridement. Hemolytic anemia developed around day 5 after spider bite (average); the lowest mean hemoglobin level was 5.8g/dL, with average drop of 3.1 g/dL. Direct antiglobulin test (DAT) (for both complement and surface immunoglobulin) was positive in 4 out of 9 patients. Four pts received glucocorticoid therapy for their hemolytic anemia. The use of steroid and intravenous immunoglobulin (IV Ig) did not seem to show a difference in the time of recovery although those who received steroids required less blood transfusion (2.1 units less). All pts had a complete recovery within two weeks. Conclusion. Treatment of systemic loxoscelism involves aggressive supportive care including appropriate wound management, blood transfusions, intravenous fluid replacement, and appropriate antibiotic coverage. It is unclear at this time if glucocorticoids or IVIg has any beneficial impact on the treatment of severe loxoscelism.

show abstract

Section: Discussionmentioning

confidence: 63%

Loxoscelism: Cutaneous and Hematologic Manifestations

Nguyen

Pandey

2019

Advances in Hematology

View full text Add to dashboard Cite

show abstract

“…A IRA está diretamente associada ao quadro cutâneo-visceral, o qual pode cursar com febre, astenia, náuseas, vômitos, hemólise, hematúria, icterícia, plaquetopenia e coagulação intravascular disseminada, podendo evoluir ao óbito (Albuquerque, Tessarolo et al 2018). A fisiopatologia da IRA está associada a pigmentúria (hemoglobinúria e mioglobinúria) secundária a hemólise e rabdomiólise (Nag, Datta et al 2014), entretanto, alguns artigos têm sugerido nefrotoxicidade direta (Melissa N.…”

Section: Aranhasunclassified

Oxalato De Cálcio

Lemos¹,

Rocha²,

Morais³

et al. 2023

Toxicologia Clínica: Animais Peçonhentos E Plantas Tóxicas Dos Biomas Do Nordeste

View full text Add to dashboard Cite

Toxicologia clínica: animais peçonhentos e plantas tóxicas dos biomas do Nordeste está licenciado sob CC BY 4.0.Esta licença exige que as reutilizações deem crédito aos criadores. Ele permite que os reutilizadores distribuam, remixem, adaptem e construam o material em qualquer meio ou formato, mesmo para fins comerciais. O conteúdo da obra e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores, não representando a posição oficial da Editora Amplla. É permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores. Todos os direitos para esta edição foram cedidos à Editora Amplla.

show abstract

“…In children, severe complications such as hemolysis, acute kidney injury, massive angioedema, and death have been reported. [5] Very few cases of spider bites producing severe angioedema have been reported from India. Here, we are presenting a unique case of severe facial angioedema in a 10-year-old girl with a brown spider bite.…”

mentioning

confidence: 99%

Cutaneous loxoscelism with severe angioedema in a child – A rare case report

Pavadai

Bhowmick

Mohanam

et al. 2022

IJSA

View full text Add to dashboard Cite

INTRODUCTIONAngioedema is localized subcutaneous or submucosal swelling, due to extravasated fluid into the interstitial tissues. Allergic angioedema, also known as histamine-mediated angioedema, is the most common variant seen in children. [1] Food allergies, insect bites or stings, and drugs are important triggers for allergic angioedema. [2] Among insects, spider bites can induce localized edema of the face, eyelids and can precipitate angioedema. [3] Spider bite is a common health hazard reported in many parts of North America, Australia, and Europe. Commonly seen spiders are of the brown variety, rarely black widow spider envenomation can also be seen. Clinical features caused by brown spider envenomation are called as loxoscelism. [4] Brown spider bite predominantly causes local inflammation progressing to dermonecrotic lesions. In children, severe complications such as hemolysis, acute kidney injury, massive angioedema, and death have been reported. [5] Very few cases of spider bites producing severe angioedema have been reported from India. Here, we are presenting a unique case of severe facial angioedema in a 10-year-old girl with a brown spider bite.

show abstract

Acute kidney injury and dermonecrosis after Loxosceles reclusa envenomation

Cited by 14 publications

References 13 publications

Loxoscelism: Cutaneous and Hematologic Manifestations

Loxoscelism: Cutaneous and Hematologic Manifestations

Oxalato De Cálcio

Cutaneous loxoscelism with severe angioedema in a child – A rare case report

Contact Info

Product

Resources

About