Description
Title: Cutaneous and hematologic symptoms of loxoscelism
Abstract: Background. Acute hemolytic anemia, rhabdomyolysis, disseminated intravascular coagulopathy (DIC), and even death can result from brown recluse spider (BRS) envenomation, which can also cause severe local reactions and systemic illnesses. Our goal is to outline the clinical characteristics and the functions of steroids and antibiotics in the treatment of loxoscelism. Methods. Nine patients (pts) who were admitted to our facility with moderate to severe loxoscelism have been identified retrospectively. A review of the patient’s chart was done to highlight significant clinical elements and the outcomes of interventions. Results. Nine patients, ranging in age from 18 to 53, were seen for jaundice, rash, pain, and fever (2). Six of these participants had records of prior spider bites. Five patients were readmitted after being discharged from the emergency room (ER) with oral antibiotics for “cellulitis” and nearly half (45%) of the patients were admitted to the intensive care unit. Sepsis secondary to cellulitis was the most frequent admissions diagnosis (6). Three patients received prompt incision and drainage (I&D) with debridement after four patients experienced worsening dermonecrosis. The average time for the onset of hemolytic anemia was day 5 after the spider bite; the lowest mean hemoglobin level was 5.8 g/dL, with an average drop of 3.1 g/dL. In 4 out of 9 patients, the direct antiglobulin test (DAT) was positive for both surface immunoglobulin and complement. To treat their hemolytic anemia, four patients received glucocorticoid therapy. Although those who received steroids needed fewer blood transfusions, the use of steroids and intravenous immunoglobulin (IV Ig) did not appear to affect how quickly patients recovered (2.1 units less) In less than two weeks, every patient had fully recovered. Conclusion. Adequate wound management, blood transfusions, intravenous fluid replacement, and appropriate antibiotic coverage are all part of the aggressive supportive care used in the treatment of systemic loxoscelism. At this time, it is unknown whether glucocorticoids or IVIg are effective in treating severe loxoscelism.
Paper Quality: SCOPUS / Web of Science Level Research Paper
Subject: Medicine
Sub Category: Hematology
Writer Experience: 20+ Years
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