Abstract
The genus Loxosceles comprises 140 species widely distributed around the world. These spiders are nocturnal, sedentary and remarkably nonaggressive, although they cause accidents in humans with wide degrees of severity, generating signs and symptoms that define the clinical condition known as loxoscelism. Its local signs and symptoms were first reported in 1872, and over the years, a large medical literature has been accumulated; unfortunately, it is not always trustworthy. Assessing the reliability of such information, we reviewed 120 case reports of loxoscelism published in 84 articles over the past 20 years. This search allowed us to gather information on the clinical aspects, diagnosis and treatment of loxoscelism, showing that the severity of these accidents has multiple degrees and that it is influenced by many factors. Thus, coupled with epidemiological and species occurrence information, this study can be a useful tool for the clinical practice of loxoscelism. It may support and provide a multidisciplinary view that should be taken into consideration when establishing the therapeutic approach in cases of Loxosceles envenomation.
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Acknowledgements
We thank Dr Rafael Marques Porto for kindly providing Loxosceles photos, CIATox/SC (Center of Information and Toxicological Assistance of Santa Catarina) for loxoscelism patients images and Alexandre Veloso for the Loxosceles illustration.
Funding
This work was supported by Centre of Toxins, Immune Response and Cell Signalling/São Paulo Research Foundation (CeTICS/FAPESP) [Grant 2013/07467-1]; FAPESP to Priscila Hess Lopes [Fellowship Grant 2015/17053-5].
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Lopes, P.H., Squaiella-Baptistão, C.C., Marques, M.O.T. et al. Clinical aspects, diagnosis and management of Loxosceles spider envenomation: literature and case review. Arch Toxicol 94, 1461–1477 (2020). https://doi.org/10.1007/s00204-020-02719-0
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DOI: https://doi.org/10.1007/s00204-020-02719-0