scholarly journals Loxoscelism: Cutaneous and Hematologic Manifestations

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ngan Nguyen ◽  
Manjari Pandey
Keyword(s):  
Hemolytic Anemia ◽  
Clinical Features ◽  
Complete Recovery ◽  
Fluid Replacement ◽  
Wound Management ◽  
Admission Diagnosis ◽  
Beneficial Impact ◽  
Systemic Symptoms ◽  
Spider Bites ◽  
Spider Bite

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. A chart review was performed to highlight important clinical features and effect of interventions. Results. Nine pts (age 18 to 53) presented with fever (6), rash (9), pain/swelling (4), and jaundice (2). Of these, 6 pts had antecedent spider bites documented. Five pts were discharged from Emergency Room (ER) with oral antibiotics for “cellulitis” and were readmitted with severe systemic symptoms, with almost half (45%) of the pts being admitted to the intensive care unit. The most common admission diagnosis was sepsis secondary to cellulitis (6). Four pts developed worsening dermonecrosis, and 3 received prompt incision and drainage (I&D) with debridement. Hemolytic anemia developed around day 5 after spider bite (average); the lowest mean hemoglobin level was 5.8g/dL, with average drop of 3.1 g/dL. Direct antiglobulin test (DAT) (for both complement and surface immunoglobulin) was positive in 4 out of 9 patients. Four pts received glucocorticoid therapy for their hemolytic anemia. The use of steroid and intravenous immunoglobulin (IV Ig) did not seem to show a difference in the time of recovery although those who received steroids required less blood transfusion (2.1 units less). All pts had a complete recovery within two weeks. Conclusion. Treatment of systemic loxoscelism involves aggressive supportive care including appropriate wound management, blood transfusions, intravenous fluid replacement, and appropriate antibiotic coverage. It is unclear at this time if glucocorticoids or IVIg has any beneficial impact on the treatment of severe loxoscelism.

scholarly journals Clinical features and outcomes of autoimmune hemolytic anemia: a retrospective analysis of 32 cases

2011 ◽  
Vol 46 (2) ◽  
pp. 111 ◽  
Author(s):  
Seung-Woo Baek ◽  
Myung-Won Lee ◽  
Hae-Won Ryu ◽  
Kyu-Seop Lee ◽  
Ik-Chan Song ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Hemolytic Anemia ◽  
Clinical Features ◽  
Autoimmune Hemolytic Anemia

Arterial Thrombosis and Gangrene Secondary to Arachnidism

Vascular ◽  
2009 ◽  
Vol 17 (4) ◽  
pp. 239-242
Author(s):  
Jan M. Eckermann ◽  
Theodore H. Teruya ◽  
Christian Bianchi ◽  
Ahmed M. Abou-Zamzam
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Vascular Disease ◽  
Tissue Damage ◽  
Arterial Thrombosis ◽  
Progressive Necrosis ◽  
Life Threatening ◽  
History Of ◽  
Spider Bites ◽  
Spider Bite

Spider bites can cause local tissue damage as well as life-threatening complications. This is a case report of a female with no history of lower extremity vascular disease who presented with a spider bite on the dorsum of her foot. She developed progressive necrosis and eventually suffered limb loss despite attempts at revascularization.

A two year study of verified spider bites in Switzerland and a review of the European spider bite literature

Toxicon ◽  
2013 ◽  
Vol 73 ◽  
pp. 104-110 ◽  
Author(s):  
Wolfgang Nentwig ◽  
Markus Gnädinger ◽  
Joan Fuchs ◽  
Alessandro Ceschi
Keyword(s):  
Spider Bites ◽  
Spider Bite

Posterior reversible encephalopathy syndrome (PRES) presenting as Status Epilepticus in a case of Autoimmune Hemolytic Anemia (AIHA): A Case report

2021 ◽  
Vol 12 (6) ◽  
pp. 102-106
Author(s):  
Sameera Dronamraju ◽  
Shilpa Gaidhane ◽  
Aayush Somani ◽  
Sourya Acharya
Keyword(s):  
Status Epilepticus ◽  
Hemolytic Anemia ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Autoimmune Hemolytic Anemia ◽  
Vasogenic Edema ◽  
Complete Recovery ◽  
Young Female ◽  
Posterior Reversible Encephalopathy ◽  
Oral Steroids ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state, caused by imbalance in autoregulation of posterior cerebral circulation. We report a case of young female, presented at emergency department with complains of nausea, vomiting and generalized tonic clonic seizures prior to admission. During the course of hospital stay patient landed in status epilepticus which was treated appropriately. Patient’s magnetic resonance imaging (MRI) was done which had classical features of vasogenic edema in occipital and parietal region, suggestive of PRES. She was a known case of autoimmune hemolytic anemia thatwas treated with multiple blood transfusions and low dose oral steroids. She was discharged after complete resolution of symptoms with the advice to follow up in medicine outpatient department. Our case describes about autoimmune hemolytic anemia in which occurrence of PRES is uncommon. Early diagnosis and robust treatment can prevent permanent damage to the brain, and is often associated with complete recovery.

Clinical features and treatment of primary autoimmune hemolytic anemia in childhood

2018 ◽  
Vol 57 (5) ◽  
pp. 665-668 ◽  
Author(s):  
Neşe Yaralı ◽  
Özlem Arman Bilir ◽  
Arzu Yazal Erdem ◽  
Vildan Çulha ◽  
Abdurrahman Kara ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Clinical Features ◽  
Autoimmune Hemolytic Anemia

The Serology and the Prognosis of 128 Cases of Autoimmune Hemolytic Anemia

Blood ◽  
1959 ◽  
Vol 14 (12) ◽  
pp. 1280-1301 ◽  
Author(s):  
JEAN DAUSSET ◽  
JACQUES COLOMBANI
Keyword(s):  
Hemolytic Anemia ◽  
Lupus Erythematosus ◽  
Autoimmune Hemolytic Anemia ◽  
Early Stage ◽  
Complete Recovery ◽  
Clinical Results ◽  
Red Cells ◽  
Coombs Test ◽  
Long Term Effect ◽  
Corticosteroid Hormones

Abstract A statistical study of 128 cases of autoimmune hemolytic anemias, serologically followed up in the same laboratory, led to some conclusions on classification, prognosis and treatment. Five forms were distinguished: 1. Idiopathic autoimmune hemolytic anemia with warm autoantibodies (IAHA-wa) was the most frequent form (65 per cent of the cases). It was observed in all peroids of life. A slight predominance among females was noted. This form was characterized clinically by a generalized or conjunctival icterus and a moderate splenomegaly. Hematologically a macrocytic normochromic anemia was present and serologically warm incomplete autoagglutinins, often nonspecific, or sometimes specific for a group antigen, were detected. Hemolysins were not found. The average course was 13 months followed by recovery (54 per cent) and 16 months followed by death (46 per cent). These two groups of patients were compared extensively. No differences in the age, sex, blood group and severity of the initial anemia were noted. A low reticulocyte count, leukopenia and association with thrombocytopenic purpura were more frequent in fatal cases. Tile persistence of a positive indirect Coombs test was unfavorable. Those with free antibodies in the plasma were the most serious. Fifty-two per cent of fatal cases had a positive indirect Coombs test. Of those who recovered, 18.5 per cent had this serologic finding. Transfusions were usually done at the begining of the disease. The efficacy of corticosteroid hormones was confirmed; the percentage of recoveries has risen since this therapy has been used fully (37.5 to 70 per cent). Early or late splenectomy had no influence on final desensitization (long-term effect), but led in 58 per cent of the cases to good clinical results (immediate effect). The spleen destroys red cells coated with noncomplement-fixing antibodies, so that splenectomy leads to compensation for the anemia. One must also describe the acute autoimmune hemolytic anemia observed especially in children, in which warm hemolysins could be detected at the very early stage of the disease. Complement was diminished or absent and the serum often showed anticomplementary activity. Complete recovery was rapid. 2. Symptomatic autoimmune hemolytic anemia with warm autoantibodies (SAHA-wa) accompanied mostly malignant conditions of the lymphocytic or reticuloendothelial systems as well as more rarely disseminated lupus erythematosus (17.6 per cent of the cases). Except for the causal disease, these cases were not different from IAHA-wa and their prognosis depended on the prognosis of the causal disorder. 3. Idiopathic autoimmune hemolytic anemia with cold antibodies (IAHAca) was less frequent (7.7 per cent of the cases). Clinically it was characterized by the rarity of splenomegaly, the chance of cold paroxysmal hemoglobinuria (1 case out of 10) and of Raynaud’s syndrome (1 case out of 10), and serologically by the presence of a cold acid-hemolysin (7 cases out of 8) along with an increased titer of complete agglutinins. Complement was diminished or absent. A positive Coombs test was possibly due to complement fixation. The course of these forms seemed to be very chronic: Nine cases of the 10 of the series were in progress for an average of 26 months, without any apparent trend to densensitization. The action of hormone therapy was less striking than in the warm variety. Splenectomy was probably not effective (1 case), since the red cells sensitized by complement-fixing antibodies were mainly recovered by the liver. 4. Symptomatic autoimmune hemolytic anemia wiith cold antibodies (SAHA-ca) was divided into two distinct forms: (a) one symptomatic of a malignant condition of the blood of the same type as in SAHA-wa (7 per cent of cases). The serology was identical to that of IAHA-ca. The prognosis was determined by that of the causal disease; (b) one symptomatic of a virus or a presumed virus infection (3.9 per cent of cases). Here an acid-hemolysin usually accompanied a very high complete cold agglutinin titer. Complete recovery occurred rapidly. In all cases with cold antibodies exposure to cold had to be carefully avoided. In cases of hemolysins, washed red cells had to be used for transfusions.

scholarly journals A toe that pointed the wrong way: An unusual presentation of tetanus

2016 ◽  
Vol 7 (01) ◽  
pp. 150-152
Author(s):  
Krishnarpan Chatterjee ◽  
Anirban Ghosh ◽  
Rimi Som Sengupta
Keyword(s):  
Blunt Trauma ◽  
Clinical Features ◽  
Antimicrobial Therapy ◽  
Passive Immunization ◽  
Complete Recovery ◽  
Unusual Presentation ◽  
History Of

ABSTRACTWe report the case of a 15-year-old girl who was initially diagnosed to have a striatal toe. Her condition progressed and she later developed clinical features consistent with tetanus. History of blunt trauma to nose was elicited retrospectively. Antimicrobial therapy with metronidazole and both active and passive immunization was started immediately. The patient went on to make a complete recovery.

Sign in / Sign up

Export Citation Format

Share Document