A rare cause of secondary hemophagocytic lymphohistiocytosis: Systemic loxoscelism

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Erat T., Yahsi A., ÇANAKÇİ C., Korkmaz A., Karahan C., Ileri T., ...More

Turkish Journal of Pediatrics, vol.62, no.4, pp.641-646, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 62 Issue: 4
  • Publication Date: 2020
  • Doi Number: 10.24953/turkjped.2020.04.014
  • Journal Name: Turkish Journal of Pediatrics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.641-646
  • Keywords: hemophagocytic lymphohistiocytosis, necrotic arachnidism, systemic loxoscelism, violin spiders, SPIDER BITES, RUFESCENS
  • Ankara University Affiliated: Yes

Abstract

© 2020, Turkish Journal of Pediatrics. All rights reserved.Background. Loxoscelism is caused by the bite of a specific spider type called the Loxosceles genus. In Turkey, most cases are seen after L. rufescens bites. Clinical manifestation of the bites ranges from local cutaneous reaction to severe ulcerative necrosis. Systemic loxoscelism may also occur. Case. Herein, we report a previously healthy five-year-old male patient who developed a secondary hemophagocytic lymphohistiocytosis after a presumed brown spider bite. He was treated with dexamethasone. Within the following 14 days, hemophagocytic syndrome resolved. Local hyperbaric oxygen therapy was applied to the necrotic areas. Conclusion. Secondary hemophagocytic lymphohistiocytosis may develop after systemic loxoscelism. In the presence of persistent fever, hepatosplenomegaly and laboratory findings this clinical entity should be kept in mind.