Persistent facial edema due to spider bite: a case of edematous cutaneous loxoscelism

Background:The bite of spiders of the Loxosceles genus causes loxoscelism.It can occur in cutaneous-necrotic, cutaneous-visceral, or predominantly edematous cutaneous loxoscelism forms.This last form is a rare variant characterized by edema without necrosis with a frequency of 5% of all cases of loxoscelism.Clinical case: A 6-year-old girl presented edema in the eyelid that progressively increased and spread to the entire face.The relative reported that this event occurred after a spider bite.Physical examination revealed a bite-type lesion on the lower left eyelid, generalized edema throughout the face, and dysphonia.The tests showed elevated creatinine and bilirubin; the rest were normal.Initially, she received corticosteroids, antihistamines, and adrenaline.Due to the persistence of edema, we administrated anti-loxosceles serum and continued with corticosteroids and antibiotics.After 48 hours, edema decreased, and on the seventh day, it was almost entirely resolved, so the patient was discharged without complications Conclusions: Predominantly edematous cutaneous loxoscelism is a rare variant.It can mimic other diseases like cellulitis or anaphylaxis in the emergency room.Supportive treatment is essential to avoid complications in children.