Severe complications in a 25‐year‐old male after brown recluse spider bite treated by therapeutic plasma exchange: A case report and review of other case studies

Although in the majority of patients (90%), the bite wound of brown recluse spider resolves spontaneously, some patients may experience a severe reaction requiring hospitalization. A 25‐year‐old male developed severe hemolytic anemia, jaundice, and other complications following a brown recluse spide...

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Bibliographic Details
Published in:Journal of clinical apheresis 2023-08, Vol.38 (4), p.505-509
Main Authors: Cain, Sarah, Plapp, Frederick V., Dasgupta, Amitava, Ye, Zhan
Format: Article
Language:English
Subjects:
Animal bites
Animals
Apheresis
Blood Transfusion
Brown Recluse Spider
brown recluse spider bite
Case reports
Hemolysis
hemolytic anemia
Humans
jaundice
Male
phospholipase D
Plasma Exchange
Spider Bites - complications
Spider Bites - therapy
Spiders
therapeutic plasma exchange
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Summary:Although in the majority of patients (90%), the bite wound of brown recluse spider resolves spontaneously, some patients may experience a severe reaction requiring hospitalization. A 25‐year‐old male developed severe hemolytic anemia, jaundice, and other complications following a brown recluse spider bite on his posterior right thigh. He was treated with methylprednisolone, antibiotics, and red blood cells (RBCs) transfusion without response. Therapeutic plasma exchange (TPE) was added to the treatment regimen, and his hemoglobin (Hb) was eventually stabilized, leading to significant clinical improvement. The beneficial effect of TPE in the current case was compared to three other reported cases. We recommend close monitoring of Hb levels in patients with systemic loxoscelism during the first week after brown recluse spider bite and early implementation of TPE in the management of severe acute hemolysis when patients do not respond to usual treatment modalities and RBC transfusion.
ISSN:0733-2459
1098-1101
DOI:10.1002/jca.22045