82 results match your criteria Spider Envenomation Brown Recluse


Atypical systemic and dermatologic loxoscelism in a non-endemic region of the USA.

Clin Toxicol (Phila) 2021 Mar 6;59(3):260-264. Epub 2020 Aug 6.

Virginia Poison Center, Division of Clinical Toxicology, Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA, USA.

Introduction: (LR), commonly known as the brown recluse spider, is endemic to the south central United States. We present a case of LR envenomation in a healthy adult male outside the usual geographic range, with atypical dermatologic and delayed, prolonged systemic loxoscelism (LX). This case demonstrates the importance of expanding the depth of knowledge of LR envenomations. Read More

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Arthropod Assault: A Case Report of Brown Recluse Envenomation in a Training Environment.

Mil Med 2020 09;185(9-10):e1880-e1881

San Antonio Uniformed Health Education Consortium, 3551 Roger Brooke Dr., San Antonio, TX 78234, USA.

Spider bites are a common emergency department complaint, accounting for ~21% of noncanine bites, injuries, and stings. Military service members, more so than most civilian personnel, are exposed to conditions that place them at increased risk for envenomation, stings, and bites. We present the case of an active duty service member working in a relatively austere environment who presented to a level 1 trauma center with a lesion consistent with a bite from a brown recluse spider, or Loxosceles reclusa. Read More

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September 2020

Cutaneous-hemolytic loxoscelism following brown recluse spider envenomation: new understandings.

Clin Toxicol (Phila) 2020 12 18;58(12):1297-1305. Epub 2020 Mar 18.

Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.

Brown recluse spider (BRS) () envenomation can cause local dermonecrotic lesions, constitutional symptoms, and potentially fatal hemolysis (i.e., cutaneous-hemolytic loxoscelism). Read More

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December 2020

Heightened Immune Response to Presumed Loxosceles reclusa Envenomation.

Wilderness Environ Med 2019 Dec 2;30(4):450-453. Epub 2019 Nov 2.

Division of Emergency Medicine, Saint Louis University School of Medicine, St. Louis, MO; Division of Toxicology, Saint Louis University School of Medicine, St. Louis, MO; Division of Pediatrics, Saint Louis University School of Medicine, St. Louis, MO.

Loxoscelism is a systemic inflammatory reaction in response to a brown recluse spider bite (BRSB). In this case we describe a patient with a heightened inflammatory response to a presumed BRSB, with Coomb's positive hemolysis, cytoplasmic antineutrophil cytoplasmic antibody (cANCA) vasculitis, and features of hemophagocytic lymphohistiocytosis (HLH). A 24-y-old female presented with sudden pain and swelling to her lower back, nausea, fever, and tachycardia after a presumed BRSB. Read More

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December 2019

Loxoscelism: Cutaneous and Hematologic Manifestations.

Adv Hematol 2019 20;2019:4091278. Epub 2019 Mar 20.

Department of Hematology and Oncology, West Cancer Clinic, 7945 Wolf River Blvd, Germantown, TN 38138, USA.

Background: Brown recluse spider (BRS) envenomation can lead to significant morbidity through severe local reaction and systemic illness including acute hemolytic anemia, rhabdomyolysis, disseminated intravascular coagulopathy (DIC), and even death. We aim to describe the clinical features and the roles of antibiotics and steroids in the treatment of loxoscelism.

Methods: We retrospectively identified nine patients (pts) at our institution who were admitted with moderate to severe loxoscelism. Read More

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Immunoprotection elicited in rabbit by a chimeric protein containing B-cell epitopes of Sphingomyelinases D from Loxosceles spp. spiders.

Vaccine 2018 11 21;36(48):7324-7330. Epub 2018 Oct 21.

Laboratory of Synthetic Biology and Biomimetics, Insituto de Ciências Biológicas, Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address:

Accidents with venomous animals pose a health issue in Brazil, and those involving brown spiders (Loxosceles sp.) figure between the most frequent ones. The accidental envenomation by brown spiders causes a strong local dermonecrotic effect, which can be followed by systemic manifestations that in some cases lead to death. Read More

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November 2018

Extracorporeal cardiopulmonary resuscitation after brown recluse envenomation.

Clin Toxicol (Phila) 2017 06 9;55(5):368-369. Epub 2017 Feb 9.

c Pediatric Intensive Care, Saint Francis Health System, Division of Pediatric Critical Care , Tulsa , OK , USA.

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[Cutaneous loxoscelism, about an exceptional observation of 9 consecutive cases].

Ann Chir Plast Esthet 2016 Dec 28;61(6):811-819. Epub 2016 Sep 28.

Département de chirurgie plastique et reconstructrice, CHRU Lapeyronie, 34295 Montpellier, France; Centre de traitement des brûlés, CHRU Lapeyronie, 34295 Montpellier, France; Unité médico-chirurgicale de plaies et cicatrisation, CHRU Picardie, 34295 Amiens, France; Unité de chirurgie plastique et craniofaciale pédiatrique, CHRU Lapeyronie, 34295 Montpellier, France. Electronic address:

Introduction: Loxosceles spiders are ubiquitous and responsible for many cases of envenomation in the world. The kind rufescens is present in the Provence and Occitan regions in France. During the summer 2015, we faced many Loxosceles rufescens cases of bites having led to extensive integumental necrosis whose features and singular evolution seems important to report. Read More

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December 2016

Immunodetection of the "brown" spider (Loxosceles intermedia) dermonecrotoxin with an scFv-alkaline phosphatase fusion protein.

Immunol Lett 2016 05 10;173:1-6. Epub 2016 Mar 10.

Laboratório de Imunoquímica, Departamento de Patologia Básica, Universidade Federal do Paraná, Curitiba CEP 81531-980, PR, Brazil. Electronic address:

Bites by spiders from Loxosceles genus often lead to a wide variance in envenomation profile of patients and diagnosis is difficult due to the number of diseases that mimic loxoscelism. In such a context, it is of interest to consider the design of standardized recombinant colorimetric antibodies for diagnosis and specific detection of individual circulating toxins in biological fluids of envenomed patients. We have previously prepared a monoclonal murine IgG (LiMab7) that reacts with Loxosceles intermedia venom components of 32-35kDa and neutralizes the dermonecrotic activity of the venom. Read More

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Therapeutic Plasma Exchange for Refractory Hemolysis After Brown Recluse Spider (Loxosceles reclusa) Envenomation.

J Med Toxicol 2015 Sep;11(3):364-7

Department of Pediatrics, Pediatric Resident, PGY 3, School of Medicine, University of Kansas, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS, 66160, USA,

Introduction: The brown recluse spider (BRS) (Loxosceles reclusa) envenomation can lead to multiple complications, including hemolysis. We present a case of refractory hemolysis after a BRS bite treated with therapeutic plasma exchange (TPE).

Case Report: A 17-year-old female presented with fever, fatigue, and dyspnea. Read More

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September 2015

Bilateral optic neuropathy following bite from brown recluse spider (Loxosceles reclusa).

Cutan Ocul Toxicol 2016 14;35(2):168-72. Epub 2015 Apr 14.

a Department of Ophthalmology and Visual Science , Havener Eye Institute, The Ohio State University , Columbus , OH , USA.

A 63-year-old female with history of a resected frontal lobe meningioma presented with bilaterally decreased vision after a bite from a brown recluse spider. The exam was significant for a left relative afferent pupillary defect, bilateral optic nerve pallor, decreased foveal sensitivity in the left eye and new bilateral visual field defects, despite stability of her meningioma. The findings remained stable at 1-year follow-up. Read More

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December 2016

Characterization of Brown spider (Loxosceles intermedia) hemolymph: cellular and biochemical analyses.

Toxicon 2015 May 24;98:62-74. Epub 2015 Feb 24.

Department of Cell Biology, Federal University of Paraná, UFPR, Curitiba, PR, Brazil. Electronic address:

This is the first study on the hemolymph from a spider of the Loxosceles genus. These animals are responsible for a great number of envenomation cases worldwide. Several studies on Loxosceles venoms have been published, and the knowledge about the venom and its toxins is considerable, not only regarding the biological and biochemical characterization, but also regarding structural, genetic and phylogenetic approaches. Read More

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Successful use of plasma exchange for profound hemolysis in a child with loxoscelism.

Pediatrics 2014 Nov;134(5):e1464-7

Divisions of Pediatric Critical Care Medicine, and.

We describe a 6-year-old boy who presented with massive hemolysis, shock, disseminated intravascular coagulopathy, and acute renal failure after loxosceles envenomation. In this patient, plasma exchange therapy (PEX) successfully cleared the plasma from an initial hemolytic index of 2000 (equivalent to 2 g/dL hemoglobin, where optimetric laboratory evaluation is impossible) to an index of <50 (no detectable hemolysis). This allowed the PICU team to correct his coagulopathy, assess his degree of organ dysfunction, and provide routine laboratory assessments during continuous venovenous hemodiafiltration. Read More

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November 2014

Acute kidney injury and dermonecrosis after Loxosceles reclusa envenomation.

Indian J Nephrol 2014 Jul;24(4):246-8

Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.

Spiders of the Loxosceles species can cause dermonecrosis and acute kidney injury (AKI). Hemolysis, rhabdomyolysis and direct toxin-mediated renal damage have been postulated. There are very few reports of Loxoscelism from India. Read More

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First report of in vitro selection of RNA aptamers targeted to recombinant Loxosceles laeta spider toxins.

Biol Res 2014 Mar 26;47. Epub 2014 Mar 26.

Background: Loxoscelism is the envenomation caused by the bite of Loxosceles spp. spiders. It entails severe necrotizing skin lesions, sometimes accompanied by systemic reactions and even death. Read More

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A randomized controlled trial of trypsin to treat brown recluse spider bites in Guinea pigs.

J Med Toxicol 2014 Sep;10(3):266-8

Department of Emergency Medicine, Brody School of Medicine, East Carolina University, 600 Moye Boulevard, Room 3ED311, Greenville, NC, 27834, USA.

Brown recluse spider bites result in necrotic skin lesions for which there is no known antidote. Since venom toxins are proteins, a proteolytic enzyme like trypsin might be effective in reducing toxicity. The aim of this study was to conduct a randomized controlled trial of trypsin to treat brown recluse spider bites in guinea pigs. Read More

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September 2014

Secondary hemophagocytic lymphohistiocytosis (HLH) from a presumed brown recluse spider bite.

J Clin Immunol 2014 Jul 16;34(5):544-7. Epub 2014 Apr 16.

Department of Pediatrics, Division of Bone Marrow Transplant and Immune Deficiency, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7015, 45229, Cincinnati, OH, USA,

Systemic loxoscelism is a rare complication after Loxosceles reclusa (brown recluse spider) envenomation. Loxosceles venom contains pro-inflammatory proteins, which have been shown to be elevated in patients with hemophagocytic lymph histiocytosis. We present a case of a 10-year-old male that developed presumed systemic loxoscelism, secondary hemophagocytic lymphohistiocytosis with hepatic dysfunction and renal failure. Read More

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Surgical treatment of a brown recluse spider bite: a case study and literature review.

J Foot Ankle Surg 2014 May-Jun;53(3):320-3. Epub 2014 Mar 22.

Nerve and Hand Surgeon, Institute for Nerve, Hand, and Reconstructive Surgery, Rutherford, NJ.

Spider bite envenomation can cause local, constitutional, and/or systemic symptoms. The present case study reports on 5 years of follow-up for a "probable" brown recluse spider bite of the foot and ankle that was refractory to conservative treatment and was subsequently treated with surgery. The present case study reports the atypical occurrence of long-term peripheral neuropathy after necrotic arachnidism induced by "probable" brown recluse (Loxosceles recluse) envenomation, in a 46-year-old male. Read More

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December 2014

Obtundation and Myocardial Infarction in a Case of Systemic Loxoscelism.

Mo Med 2014 Mar-Apr;111(2):143-147

Karen Schilli, MS, Ryan Rader, BS, Katie Payne, and William Stoecker, MD, MS, MSMA member since 1984, are with Stoecker & Associates, Rolla, Missouri. Jonathan Green, PhD, is with the University of Missouri College of Agriculture, Food and Natural Resources, Columbia.

We report an atypical course of a likely brown recluse spider bite in a 79-year-old male. The Rader scale and venom detection by ELISA provide supporting evidence for a loxoscelism diagnosis. Obtundation and myocardial infarction occurred following a drop in hemoglobin to 6. Read More

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October 2018

Clinicopathological course of acute kidney injury following brown recluse (Loxoscles reclusa) envenomation.

Clin Kidney J 2013 Dec 1;6(6):609-12. Epub 2013 Oct 1.

Department of Medicine , Washington University School of Medicine , St Louis , MO , USA.

We report a case of severe systemic loxoscelism in a previously healthy young man. This was associated with a Coombs-positive hemolytic anemia, striking leukomid reaction, renal failure, respiratory failure and cardiovascular collapse. This is the first documented case of a renal biopsy in a patient with renal failure after envenomation by the brown recluse spider. Read More

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December 2013

Brown Recluse spider bite mediated hemolysis: clinical features, a possible role for complement inhibitor therapy, and reduced RBC surface glycophorin A as a potential biomarker of venom exposure.

PLoS One 2013 27;8(9):e76558. Epub 2013 Sep 27.

Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.

Background: The venom of Loxosceles reclusa (Brown Recluse spider) can cause a severe, life-threatening hemolysis in humans for which no therapy is currently available in the USA beyond supportive measures. Because this hemolysis is uncommon, relatively little is known about its clinical manifestation, diagnosis, or management. Here, we aimed to clarify the clinical details of envenomation, to determine the efficacy of the complement inhibitor eculizumab to prevent the hemolysis in vitro, and to investigate markers of exposure to Brown Recluse venom. Read More

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Phospholipase D toxins of brown spider venom convert lysophosphatidylcholine and sphingomyelin to cyclic phosphates.

PLoS One 2013 29;8(8):e72372. Epub 2013 Aug 29.

Department of Chemistry and Biochemistry, University of Arizona, Tucson, Arizona, USA.

Venoms of brown spiders in the genus Loxosceles contain phospholipase D enzyme toxins that can cause severe dermonecrosis and even death in humans. These toxins cleave the substrates sphingomyelin and lysophosphatidylcholine in mammalian tissues, releasing the choline head group. The other products of substrate cleavage have previously been reported to be monoester phospholipids, which would result from substrate hydrolysis. Read More

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Two successive necrotic lesions secondary to presumed loxosceles envenomation.

Wilderness Environ Med 2013 Jun 24;24(2):132-5. Epub 2013 Jan 24.

Department of Emergency Medicine, Truman Medical Center, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, USA.

Brown recluse spider (Loxosceles reclusa) envenomations with subsequent necrotic skin lesions occur infrequently, and systemic loxoscelism is rarer still. We report a case of 2 successive developing necrotic lesions, each on adjacent medial aspects of the legs, secondary to presumed Loxosceles envenomation. A 31-year-old man with no significant past medical history presented to the emergency department with 2, large, necrotic lesions, 1 on each medial thigh. Read More

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Brown recluse spider bite to the upper lip.

J Ark Med Soc 2012 Mar;108(10):208-10

Brown recluse spiders are predominantly found in south central United States. Their bites usually cause mild self-limiting reactions, although localized tissue necrosis and rare systemic, potentially fatal, envenomations are known to occur. Herein, we report an atypical presentation of a brown recluse bite in a 20 year old female who was admitted to the intensive care unit due to angioedema and cellulitis. Read More

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Emergency department death from systemic loxoscelism.

Ann Emerg Med 2012 Oct 2;60(4):439-41. Epub 2012 Feb 2.

Vanderbilt University Medical Center, Department of Emergency Medicine, Nashville, TN, USA.

Systemic loxoscelism is a constitutional illness resulting from the bite of the brown recluse spider. In severe form, it may cause hemolysis, acute renal failure, and disseminated intravascular coagulation. More rarely, it may result in death. Read More

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October 2012

Acute generalized exanthematous pustulosis and Coombs-positive hemolytic anemia in a child following Loxosceles reclusa envenomation.

Pediatr Dermatol 2011 Nov-Dec;28(6):685-8. Epub 2011 Mar 15.

Department of Dermatology, University of Missouri, Columbia, Missouri 65212, USA.

Previously reported cases of acute generalized exanthematous pustulosis secondary to brown recluse spider bite have been questioned due to lack of identification of the spider or because of the concomitant administration of antibiotics. We report a 9-year-old boy who arrived at the emergency department with a confirmed Loxosceles reclusa bite to the neck. On the third day of hospitalization, he developed hundreds of monomorphous, sterile pustules, initially in intertriginous areas. Read More

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[Cutaneous necrotic loxoscelism. A case report].

Rev Alerg Mex 2011 May-Jun;58(3):171-6

Médico adscrito.

Brown recluse (Loxosceles spp.) spiders are arachnid species known to cause necrotic arachnidism. The envenomation, described as loxoscelism, is associated with localized pain, erythema, and edema followed by the development of necrosis. Read More

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Seasonality of brown recluse spiders, Loxosceles reclusa, submitted by the general public: implications for physicians regarding loxoscelism diagnoses.

Authors:
Richard S Vetter

Toxicon 2011 Dec 28;58(8):623-5. Epub 2011 Sep 28.

Department of Entomology, University of California, Riverside, USA.

Many medically important animals exhibit fluctuating seasonal abundance such that risk from envenomation or disease is not constant throughout the year. As indicated by homeowner submissions, brown recluse spiders, Loxosceles reclusa, show seasonal peaks of activity during summer and paucity in winter. This information should be incorporated as part of the diagnostic algorithm for physicians when considering the probability of loxoscelism in endemic Loxosceles areas especially if a skin lesion occurs when spiders are scarce. Read More

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December 2011