Williams S T, Khare V K, Johnston G A, Blackall D P
Department of Pathology, University of Tennessee College of Medicine, Memphis 38163, USA.
Am J Clin Pathol. 1995 Oct;104(4):463-7. doi: 10.1093/ajcp/104.4.463.
Envenomation by the brown recluse spider (loxoscelism) is classically associated with a necrotic ulcer. Systemic manifestations occur in a minority of cases, but are generally mild and self-limited. The hematologic complications of brown recluse spider bite range from mild hemolysis to fulminant intravascular hemolysis with or without evidence of disseminated intravascular coagulation. Intravascular hemolysis is a rare but occasionally lethal complication of brown recluse spider envenomation. This article presents two cases of severe hemolysis associated with loxoscelism occurring in two young women in Memphis, Tennessee. The second documented death in an adult from severe hemolysis due to a brown recluse spider bite is reported. A review of the literature emphasizing the pathogenic mechanisms of spider bite hemolysis is also included.
棕色隐士蜘蛛咬伤（洛矶山蜘蛛中毒）通常会导致坏死性溃疡。全身症状在少数病例中出现，但一般较轻且具有自限性。棕色隐士蜘蛛咬伤的血液学并发症范围从轻度溶血到暴发性血管内溶血，伴或不伴有弥散性血管内凝血的证据。血管内溶血是棕色隐士蜘蛛中毒罕见但偶尔致命的并发症。本文介绍了田纳西州孟菲斯市两名年轻女性发生的与洛矶山蜘蛛中毒相关的严重溶血病例。报告了第二例因棕色隐士蜘蛛咬伤导致严重溶血的成人死亡病例。本文还包括对强调蜘蛛咬伤溶血致病机制的文献综述。
