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Case Reports in Emergency Medicine
Volume 2016 (2016), Article ID 7640789, 4 pages
http://dx.doi.org/10.1155/2016/7640789
Case Report

Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution

Anaesthesia and Intensive Care Unit, General Hospital “Pugliese-Ciaccio”, Viale Pio X, 88100 Catanzaro, Italy

Received 21 April 2016; Revised 26 July 2016; Accepted 15 August 2016

Academic Editor: Vasileios Papadopoulos

Copyright © 2016 Mario Pezzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe.