Dermonecrotic arachnidism: report of two patients

Ramesh, Sandhiya; Rao, Raghavendra

doi:10.1111/ijd.14881

Cited by 1 publication

(3 citation statements)

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“…Similar findings were described by Sandhiya and Rao in two patients who had painful indurated plaque over the lower abdomen following a bite, which progressed to a blister with surrounding erythema and eschar followed by ulceration. Haematological and biochemical parameters were within normal limits, and both patients were discharged after conservative management 5. Another author reported pulsatile pain followed by an abscess 2 days after the bite, which was managed by surgical debridement.…”

Section: Discussionmentioning

confidence: 92%

“…Furthermore, the toxin causes intravascular haemolysis, aggregation of platelets, and activates the complement system. The bite reaction may resemble pyoderma gangrenosum, erythema migrans, cutaneous anthrax, and scorpion bites 5…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of spider envenomation tried previously includes rest, ice compression and elevation (RICE therapy) to minimise inflammation and venom spread,8 platelet-rich fibrinogen dressings at weekly intervals for wound healing,5 antivenom, corticosteroids and dapsone. Indications for antivenom therapy depend mainly on the time of progression—the earlier the therapy, the greater its efficacy.…”

Section: Discussionmentioning

confidence: 99%

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Acute necrotic arachnidism with necrotising fasciitis and recurrent pneumothorax

2022

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A male infant presented with swelling of the left leg and fever. Over the next 2 days, the area developed fasciitis extending to the left thigh, abdomen, and lower chest. Meanwhile, the parents found a giant brown spider within the infant’s cot belonging to the genusLoxosceles, otherwise called the brown recluse spider. The dermo-myonecrosis progressed to deeper tissues involving the lung parenchyma requiring invasive ventilation. CT of the thorax showed multiple pneumatoceles, and lung biopsy showed alveolar necrosis. The infant was treated with intravenous antibiotics and corticosteroids. We drained the pneumothoraces by thoracostomy and insertion of intercostal drainage tubes. The infant required respiratory support initially by conventional ventilation, which was escalated to high-frequency oscillatory ventilation. He had refractory hypoxaemia and died. This is the first fatal case of acute spider envenomation described in India. Spider envenomation must be considered in patients with sudden onset, rapidly progressive necrotising fasciitis unresponsive to antibiotic therapy.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%