Edwards J J, Anderson R L, Wood J R
Arch Ophthalmol. 1980 Nov;98(11):1997-2000. doi: 10.1001/archopht.1980.01020040849012.
Loxoscelism is a reaction to the bite of spiders of the genus Loxosceles. Several species have been found in the United States; the most commonly encountered is L reclusus, the small brown recluse spider. Two types of reactions occur from the bite. In the localized type, necrotic loxoscelism, a cutaneous lesion with extensive gangrene develops. About 25% of patients have systemic manifestations of viscerocutaneous loxoscelism. There is the same local reaction, but, in addition, fever, chills, vomiting, joint pain, and hematologic abnormalities occur. Hemoglobinemia and hemoglobinuria suggest severe involvement. Deaths are believed to be caused by massive intravascular hemolysis. We describe a 61-year-old man who was bitten on the periorbital region; viscerocutaneous loxoscelism with gangrenous involvement of the eyelids developed. Severe laryngeal edema from regional, massive swelling of his neck was life threatening.
褐蛛中毒是对褐蛛属蜘蛛叮咬的一种反应。在美国已发现几种褐蛛；最常见的是褐隐士蛛，即棕色小隐士蛛。褐蛛叮咬会引发两种类型的反应。在局部型，即坏死性褐蛛中毒中，会出现伴有广泛坏疽的皮肤损伤。约25%的患者会出现皮肤内脏型褐蛛中毒的全身症状。会有相同的局部反应，但除此之外，还会出现发热、寒战、呕吐、关节疼痛和血液学异常。血红蛋白血症和血红蛋白尿提示病情严重。据信死亡是由大量血管内溶血所致。我们描述了一名61岁男性，其眶周区域被叮咬；出现了皮肤内脏型褐蛛中毒，眼睑出现坏疽。颈部局部大量肿胀导致严重的喉水肿，危及生命。
