Loxoscelism in an HIV patient

The complexity behind a spider bite

Abstract

Loxoscelism is a relatively common toxinological event in tropical countries. Although most are self-limiting, some cases may have serious local or systemic consequences. Unfortunately, lack of knowledge and limited diagnostic and treatment strategies still result in adverse outcomes in susceptible patients.

The aim of this paper is to present a clinical case of serious loxoscelism in an HIV patient, highlighting the correlation between the clinical presentation and the toxinological characteristics of the poison. This was a previously healthy 48-year-old male patient with risky sexual habits, who experienced a serious arachnid accident after being bitten by a spider of the Loxosceles genus. He subsequently experienced a difficult clinical course, with deep vein thrombosis, progressively increasing transaminases to the range of hepatitis, and a de novo diagnosis of HIV, confirmed by fourth generation ELISA.

This is the first case report of arachnidism in the context of HIV infection, which opens a discussion on the possible differential response of this population to the effects of spider poison