Laboratory Testing in Monitoring the Effects of Brown Recluse Spider Bites

Abstract

Brown recluse spiders are endemic to the central United States and are highly venomous. Although most brown recluse spider bites do not cause dangerous wounds or systemic symptoms, severe cases can occur. Changes in laboratory values may include hemolysis, thrombocytopenia, coagulopathy, and altered chemistry and urinalysis results. Neutrophil involvement in wound progression and white blood cell changes can be observed. If blood products are indicated, fresh frozen plasma and cryoprecipitate should be avoided. There is no single clinical lab test that can be used to diagnose a brown recluse spider bite, but laboratory involvement in monitoring progression and treatment may be significant.

Local Dermonecrosis with Generalized Urticaria Probably Due to Loxosceles rufescens Bite

“…The severity of clinical condition also depends on individual immune response and the amount of the injected venom: 90% of bites heal without complications and, in other 10%, not every symptom or sign which characterized loxoscelism must be necessary be present. The presence of the skin lesion without other systemic parameters such as fever and negative blood tests do not exclude the hypothesis of brown recluse spider bite, but on the other hand, she might have developed them but without any laboratory test to demonstrate it [5], [16], [17].…”

“…There is no diagnostic test available to quickly help the physician make a diagnostic or therapeutic decision, but a rapid diagnosis is crucial for satisfactory treatment [7], [12]. In the present paper, a case, which we presumed to be due to the bite of Loxosceles rufescens, is evaluated in the light of literature [13], [14], [15], [16], [17], [18], [19], [20], [21].…”

Pulmonary involvement from animal toxins: the cellular mechanisms

“…Spider cytotoxin, such as phospholipase D (sphingomyelinase D) from recluse spiders ( Loxosceles spp. ), can directly disrupt the alveolar cell membrane and indirectly lead to cytokine storms resulting in pulmonary edema [ 39 , 40 ]. The presence of proteases, cytotoxins, and vasodilative peptides in stonefish venom (family Synanceja) caused lung edema, inflammation, and hemorrhage in animals and cardiogenic or non-cardiogenic pulmonary edema in human case reports [ 41 , 42 ].…”