Loxoscelism of the eyelids

Area of Science:

• Toxicology
• Dermatology
• Internal Medicine

Background:

• Loxoscelism results from the bite of Loxosceles spiders, with L. reclusus being common in the US.
• Reactions range from localized necrotic skin lesions to systemic viscerocutaneous loxoscelism.
• Systemic symptoms include fever, vomiting, joint pain, and dangerous hematologic abnormalities like hemolysis.

Observation:

• A 61-year-old man presented with a bite on the periorbital region.
• He developed viscerocutaneous loxoscelism with gangrene of the eyelids.
• Massive neck swelling led to life-threatening laryngeal edema.

Findings:

• The patient experienced severe local and systemic reactions to the spider bite.
• Hemoglobinemia and hemoglobinuria indicated severe systemic involvement, likely due to intravascular hemolysis.
• The case highlights the potential for severe, life-threatening complications.

Implications:

• This case underscores the severity of Loxosceles spider bites, particularly viscerocutaneous loxoscelism.
• Prompt recognition and management are crucial for potentially fatal complications like laryngeal edema.
• Understanding the spectrum of Loxoscelism is vital for effective patient care and outcomes.