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Updated: Jan 25, 2026
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Dual-mode Imaging of Cutaneous Tissue Oxygenation and Vascular Function
Published on: December 8, 2010
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Loxoscelism: Cutaneous and Hematologic Manifestations.
Ngan Nguyen1, Manjari Pandey2,3
1Department of Internal Medicine, University of Tennessee Health Science Center, 956 Court Ave., Suite H314, Memphis, TN 38163, USA.
Advances in Hematology
|April 25, 2019
Summary
Brown recluse spider envenomation can cause severe illness. Aggressive supportive care is key, but the benefits of steroids and IVIg for severe loxoscelism remain unclear.
Area of Science:
- Toxicology
- Dermatology
- Hematology
Background:
- Brown recluse spider (BRS) envenomation can lead to severe local reactions and systemic illness, including acute hemolytic anemia, rhabdomyolysis, and disseminated intravascular coagulopathy (DIC).
- Loxoscelism, the condition resulting from BRS bites, can cause significant morbidity and mortality.
Purpose of the Study:
- To describe the clinical features of moderate to severe loxoscelism.
- To evaluate the roles of antibiotics and steroids in treating loxoscelism.
Main Methods:
- Retrospective review of nine patients admitted with moderate to severe loxoscelism.
- Chart review to identify clinical features and the effects of interventions.
Main Results:
- Patients presented with fever, rash, pain, swelling, and jaundice. Six patients had documented spider bites.
- Four patients developed dermonecrosis, and three underwent incision and drainage with debridement.
- Hemolytic anemia occurred around day 5 post-bite; four patients had positive direct antiglobulin tests. Steroid therapy was associated with fewer blood transfusions.
Conclusions:
- Treatment of systemic loxoscelism requires aggressive supportive care, including wound management, blood transfusions, and antibiotics.
- The beneficial impact of glucocorticoids or intravenous immunoglobulin (IVIg) on severe loxoscelism treatment is currently uncertain.
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