Surgical Treatment of a Brown Recluse Spider Bite: A Case Study and Literature Review

Delasotta, Lawrence A.; Orozco, Fabio; Ong, Alvin; Sheikh, Emran

doi:10.1053/j.jfas.2014.01.009

Cited by 12 publications

(14 citation statements)

References 26 publications

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“…These alternatives can be costly, painful, and/or toxic. 3,5,10 None of these treatments have been proven to be effective in patients' recovery. Most bites are self-limiting and heal without intervention.…”

Section: Discussionmentioning

confidence: 99%

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Skin Necrosis, Diffuse Urticaria, and Cellulitis Due to Presumed Loxosceles Spider Bite

Köse

Abacı

Babuş

et al. 2021

Wilderness & Environmental Medicine

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The clinical manifestations of a recluse spider bite range from local erythema to necrotic skin reactions; bites rarely lead to a systemic disease known as viscerocutaneous loxoscelism. A 29-y-old female patient was admitted to the emergency department with a wound, swelling, and pain on her left leg and a rash on her whole body as a result of a spider bite. On physical examination, a round, hard, black, irregularly shaped necrotic area was found in the bite zone on the lower posterior part of the left thigh, as were lesions in the form of erythematous papules around the area. There was a color change around the lesion, extending from posterior to medial of the thigh, and a papule on a diffuse erythematous surface on the trunk and arms. At follow-up, the necrotic area had become more apparent. After approximately 1 mo, the necrotic area was surgically debrided and a flap was formed on the necrotic tissue area. In this article, a case that was thought to be caused by a Loxosceles spider bite and which started with erythema, progressed to lymphangitis, cellulitis, and severe necrosis, and was surgically debrided, was evaluated in light of the clinical findings and previously reported cases of verified loxoscelism. In patients with a history suggestive of a bite and with these clinical findings, the diagnosis of a bite by Loxosceles spp. should be carefully considered based on clinical and epidemiologic findings.

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Section: Discussionmentioning

confidence: 99%

“…Most bites are self-limiting and heal without intervention. 3,5,10 Analgesic, antihistaminic, steroid, and antibiotic treatments were given to our patient because of itching, diffuse urticaria lesions, cellulitis, and skin necrosis. The clinical findings disappeared in 3 wk, except for skin necrosis.…”

Section: Discussionmentioning

confidence: 99%

Skin Necrosis, Diffuse Urticaria, and Cellulitis Due to Presumed Loxosceles Spider Bite

Köse

Abacı

Babuş

et al. 2021

Wilderness & Environmental Medicine

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“…The terminal evolution of loxoscelism can induce severe intravascular hemolysis associated with acute anemia, jaundice, and hemoglobinuria of varying degrees. Fatalities are rare, but frequently correlated with acute renal failure [8, 9].…”

Section: Introductionmentioning

confidence: 99%

“…However, this polytherapy is not completely effective in reducing skin lesions and restoring the affected tissue. In many situations, dermonecrosis is so extensive that it requires skin grafts [9].…”

Section: Introductionmentioning

confidence: 99%

Effects of copaiba oil on dermonecrosis induced by Loxosceles intermedia venom

Ribeiro

Oliveira

Souza

et al. 2019

J. Venom. Anim. Toxins incl. Trop. Dis

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Background: Accidents caused by spiders of the genus Loxosceles constitute an important public health problem in Brazil. The venom of Loxosceles sp induces dermonecrosis at the bite site and systemic disease in severe cases. Traditional medicine based on plant-derived products has been proven to reduce the local effects of envenomation. The present study verified the healing effects of copaiba oil on lesions induced by the venom of L. intermedia. Methods: Cutaneous lesions were induced on the backs of rabbits by intradermal injection of L. intermedia venom. Copaiba oil was applied topically 6 hours after injection; the treatment was repeated for 30 days, after which animal skins were removed and processed for histopathological analysis. Blood samples were also collected before and 24 hours after venom inoculation to measure the hematological parameters. Results: Compared to the control group, the platelet count was reduced significantly in all groups inoculated with venom, accompanied by a decreased number of heterophils in the blood. The minimum necrotic dose (MND) was defined as 2.4 μg/kg. Topical treatment with copaiba oil demonstrated a differentiated healing profile: large skin lesions were observed 10 days after venom inoculation, whereas formation of a thick crust, without scarring was observed 30 days after venom inoculation. Histopathological analysis showed no significant difference after treatment. Nevertheless, the copaiba oil treatment induced a collagen distribution similar to control skin, in marked contrast to the group that received only the spider venom injection. Conclusions: We conclude that copaiba oil may interfere in the healing process and thus propose it as a possible topical treatment for cutaneous lesions induced by L. intermedia venom.

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“…Therapy for necrotic arachnidism is mostly based on surgical debridement, moist wound dressings, and reconstruction through split‐thickness skin grafts or local flaps . Other treatments include corticosteroids in case of systemic reactions such as hemolysis, antihistamines, dapsone, hyperbaric oxygen, compression, prophylactic antibiotics, tetanus prophylaxis in susceptible individuals, antivenoms, or other wound healing adjuvant devices such as negative pressure wound therapy (NPWT) …”

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confidence: 99%