Loxoscelism or necrotic arachnidism are the terms used to describe the effects of the brown recluse spider bite. Over recent years, there has been a steady increase in the number of reported brown recluse spider bites. It is not clear whether this represents an expanded range of the spider's habitat or greater physician awareness. Although most commonly found in the warm, south central region of the United States, Loxosceles reclusa can be a cause of necrotic arachnidism in northern urban settings. Therefore, the diagnosis should also be considered in these areas. This article discusses three cases of suspected brown recluse spider bites referred to a Chicago-based poison control center and briefly reviews the literature regarding the diagnosis, clinical presentation and treatment of loxoscelism.
References
1.
SvensonF.J.Treatment of clinically diagnosed brown recluse spider bites with hyperbaric oxygen: a clinical observation. J Arch Med Soc1986; 83, 199–204
2.
Venomous recluse spider bites suspected in Ohio bites. Detroit Free Press 1989; July 9, p. 4A.
3.
Greenberg, B. Personal communication. Dept of Biological Sciences, University of Illinois at Chicago.
4.
AuerA.I.HerseyF.B.Surgery for necrotic bites of the brown spider. Arch Surg1974; 108, 612–618
5.
Wasserman, G.S. and Anderson, P.C. Loxoscelism and necrotic arachnidism. J Tox Clin Tox 1983–84; 21, 451–72.
6.
CavenessW.Insect bite complicated by fever. Nashville J Med Surg1872; 10, 333–337
7.
AtkinsJ.A.CurtisW.W.SodemanW.A.Probable cause of necrotic spider bite in the midwest. Science1957; 126, 73
8.
ReesR.R.CampbellD.S.Spider bites. In: AuerbachP.S.GeehrE.C. eds. Management of Wilderness and Environmental Emergencies. 2nd ed.St. Louis: C.V. Mosby Co, 1989, 543–561
ForresterL.J.BarrettJ.T.CampbellB.J.Serodiagnostic test for loxosceles reclusa bites. Clin Tox1974; 7, 375–382
14.
HuffordD.C.MorganP.N.C-reactive protein as a mediator in the lysis of human erythrocytes sensitized by brown recluse spider venom. Proc Soc Exp Bio Med1981; 167, 493–497
15.
SmithC.W.MicksD.W.The role of PMN leukocytes in the lesion caused by the venom of the brown recluse spider L. reclusa. Lab Invest1970; 22, 90–93
16.
BergerR.S.AdelsteinE.H.AndersonP.C.Intravascular coagulation: the cause of necrotic arachnidism. J Invest Derm1973; 61, 142–150
17.
RussellF.E.GertsschW.J.Letter to the editor. Toxicon1983; 21, 337–339
18.
BergerR.S.MillikinL.E.ConwayF.An in vitro test for Loxosceles reclusa spider bites. Toxicon1973; 11, 465–470
19.
BarrettS.M.JenkinsM.R.CampbellJ.P.Passive hemagglutination inhibition test for the diagnosis of brown recluse spider bite envenomation. Ann Emerg Med1989; 18, 441
20.
RussellF.E.Jaws that bite, things that sting. Emerg Med1978; 10, 24–59
21.
AndersonP.C.Necrotizing spider bites. American Fam Phys1982; 26, 198–203
22.
HuntG.R.Bites and stings of uncommon arthropods: spiders. Postgrad Med1981; 70, 91–102
23.
KingL.E.ReesR.S.Treatment of brown recluse spider bites. J Amer Acad Derm1986; 14, 691–692
24.
NanceW.E.Hemolytic anemia of necrotic arachnidism. Amer J Med1961; 31, 801–807
25.
EllenhornM.BarcelouxD.Medical Toxicology: Diagnosis and Treatment of Human Poisonings. New York: Elsevier, 1988: Part V: Natural Toxins, 1146–56
26.
ReesR.S.CampbellD.RiegerE.et al.The diagnosis and treatment of brown recluse spider bites. Ann Emerg Med1987; 16, 945–949
27.
WassermanG.S.Wound care of spider and snake envenomations. Ann Emerg Med1988; 17, 119–123
