Sudden unexplained hemolysis occurring in an infant due to presumed Loxosceles envenomation.
We report the case of a 3-week-old infant referred for evaluation of sudden onset jaundice and unexplained hemolysis. After an exhaustive workup, the most likely etiology was found to be envenomation by a brown recluse spider, Loxosceles reclusa. This case underscores the fact that severe loxoscelism may occur in the absence of the classically described necrotic cutaneous lesion, and represents one of the youngest presumed cases of loxoscelism. We present the case to illustrate the importance of considering loxoscelism in the differential diagnosis of sudden massive hemolysis in children, particularly in endemic areas of the midwestern and southern United States.
Department of Pediatrics, Division of Emergency Medicine, St. Louis Children's Hospital, St. Louis, Missouri, USA.
Mark A
MA
Hostetler
William
W
Dribben
David B
DB
Wilson
William J
WJ
Grossman
D000743:Anemia, Hemolytic / Q000209:etiology / Q000628:therapy; D000818:Animals; D005260:Female; D006461:Hemolysis; D006801:Humans; D007231:Infant, Newborn; D010727:Phosphoric Diester Hydrolases / Q000506:poisoning*; D001098:Spider Bites; D013111:Spider Venoms / Q000506:poisoning*; D013112:Spiders
D013111:Spider Venoms; C055161:loxosceles venom; D010727:Phosphoric Diester Hydrolases