Tuğba ERAT, Aysun YAHŞİ, Cem ÇANAKÇI, Aybike KORKMAZ, Ceyda KARAHAN, Talia İLERİ, Savaş SEREL, Huban ATİLLA, Nihal KUNDAKÇI, Halil ÖZDEMİR, Erdal İNCE, Ergin ÇİFTÇİ

A rare cause of secondary hemophagocytic lymphohistiocytosis: systemic loxoscelism

Background. Loxoscelism is caused by the bite of a specific spider type called the Loxosceles genus. In Turkey, most cases are seen after L. rufescens bites. Clinical manifestation of the bites ranges from local cutaneous reaction to severe ulcerative necrosis. Systemic loxoscelism may also occur. Case. Herein, we report a previously healthy five-year-old male patient who developed a secondary hemophagocytic lymphohistiocytosis after a presumed brown spider bite. He was treated with dexamethasone. Within the following 14 days, hemophagocytic syndrome resolved. Local hyperbaric oxygen therapy was applied to the necrotic areas. Conclusion. Secondary hemophagocytic lymphohistiocytosis may develop after systemic loxoscelism. In the presence of persistent fever, hepatosplenomegaly and laboratory findings this clinical entity should be kept in mind.

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