Lymphedema as Consequence of Loxosceles Brown Spider Bite: A Case Report and Literature Review
Luis E. L. Montoya
*
Fi Fisioterapia Integral S.C. Research Group, Calle San Juan Bosco 1333, Col. Camino Real, C. P. 45040, Zapopan, Jalisco, México.
Maria T. Zarate-Sánchez
Fi Fisioterapia Integral S.C. Research Group, Calle San Juan Bosco 1333, Col. Camino Real, C. P. 45040, Zapopan, Jalisco, México and Universidad Marista Valladolid, José Juan Tablada 1111, Santa Maria de Guido C.P. 58090, Morelia, Mich, Mexico.
K. Gabriela Saenz-Ramirez
Fi Fisioterapia Integral S.C. Research Group, Calle San Juan Bosco 1333, Col. Camino Real, C. P. 45040, Zapopan, Jalisco, México and Universidad Marista Valladolid, José Juan Tablada 1111, Santa Maria de Guido C.P. 58090, Morelia, Mich, Mexico.
Yucari Lopez-Cabanillas
Fi Fisioterapia Integral S.C. Research Group, Calle San Juan Bosco 1333, Col. Camino Real, C. P. 45040, Zapopan, Jalisco, México.
Joceline Sandoval-Aguirre
Fi Fisioterapia Integral S.C. Research Group, Calle San Juan Bosco 1333, Col. Camino Real, C. P. 45040, Zapopan, Jalisco, México.
Angel L. Montoya
Fi Fisioterapia Integral S.C. Research Group, Calle San Juan Bosco 1333, Col. Camino Real, C. P. 45040, Zapopan, Jalisco, México.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Secondary lymphedema is defined as a chronic-progressive disease that causes rich protein edema of the limbs, this may be caused due to the damage or obstruction of lymphatic structures; complications associated with loxosceles spider bite may cause damage to the lymphatic system.
Objective: To describe the clinical case of a patient with lower extremity lymphedema secondary to loxosceles' spider bite complications and to present a literature review on the topic.
Case Presentation: A 24-year-old man received previous medical attention between 2020-and 2021 due to complications of a loxosceles brown spider bite. He arrived at our facilities in January 2022 to assess his case related to progressive volume leg increase and a chronic wound in the bitten site. After the clinical history analysis, physical examination, and a near-infrared lymphography study of the leg, damage to lymphatic structures was identified; secondary lymphedema was confirmed. It was possible to reverse and control the lymphedema volume and the wound evolved to complete closure. The case is presented along with a literature review on the topic.
Conclusion: It is presented a case of lymphedema associated with a loxosceles brown spider bite, and successfully treated. Lymphedema related to a loxosceles spider bite and its complications is a clinical reality that might be underrecognized by scientific literature and clinicians; this condition should be properly studied and considered with adequate assessment strategies in patients after suffering the spider bite in extremities, especially in the mid and long-term.
Keywords: Lymphedema, secondary lymphedema, loxosceles bite, near-infrared lymphatic imaging, NIR lymphography, brown spider, violinist spider