Additional considerations in presumptive brown recluse spider bites and dapsone therapy

Distribution and medical aspects of Loxosceles rufescens, one of the most invasive spiders of the world (Araneae: Sicariidae)

Loxosceles rufescens is a circum-Mediterranean spider species, potentially harmful to humans. Its native area covers the Mediterranean Basin and Near East. Easily spread with transported goods, it is meanwhile an alien and invasive species to nearly all other continents and many islands. This species occurs in semi-arid steppe-like habitats, typically under stones and in cavities, which enables it to settle inside buildings when invading the synanthropic environment. This review analyses the literature of L. rufescens bites to humans (38 publications) of which only 11 publications refer to 12 verified spider bites (11% of the reported bites). Two published allegedly deadly spider bites (Thailand 2014 and Italy 2016) involve non-verified spider bites and are thus not reliable. The symptoms and therapy of these 11 verified bites are described: only five cases showed moderate systemic effects, nine cases developed necrosis, four cases needed surgical debridement, all cases healed without complications within a few weeks. In conclusion, L. rufescens is a spider species globally spread by human activity, it rarely bites humans and the bites are less harmful than often described. There is no known fatal issue.

Distribution of the brown recluse spider (Araneae: Sicariidae) in Illinois and Iowa

The medical importance of the brown recluse spider, Loxosceles reclusa Gertsch and Mulaik, is well known, but there is a need for more accurate information about the distribution of the spider in North America. We gathered information via an Internet offer to identify spiders in Illinois and Iowa that were thought to be brown recluses. We also mined brown recluse locality information from other agencies that kept such records. In Iowa, the brown recluse is unknown from its northern counties and rare in southern counties. In Illinois, brown recluse spiders are common in the southern portion of the state and dwindle to almost nonexistence in a transition to the northern counties. Although there were a few finds in the Chicago, IL area and its suburbs, these are surmised to be human-transported specimens and not part of naturally occurring populations. Considering the great human population density and paucity of brown recluses in the Chicago area, medical personnel therein should obtain patient geographic information and be conservative when diagnosing loxoscelism in comparison with southern Illinois, where the spiders are plentiful and bites are more likely.

Brown recluse spider bites: a case report

The brown recluse spider is found more commonly in the Southeast and the Central Midwest. Its bite is not common because it is a shy spider that only bites if cornered. A severe bite may necrose a large area that requires skin grafting; systemic reactions rarely occur. This article discusses the brown recluse spider and presents a case study of a patient with two spider bites that did require extensive grafting.

Reports of envenomation by brown recluse spiders (Araneae: Sicariidae) outnumber verifications of Loxosceles spiders in Florida

Bites attributed to the brown recluse spider, Loxosceles reclusa Gertsch & Mulaik, are frequently reported by medical personnel throughout Florida, whereas the extensive arachnological evidence contradicts the alleged widespread occurrence of Loxosceles spiders in the state. We compared reports of brown recluse spider bites made by medical personnel from a 6-yr Florida poison control center database to the known verifications of Loxosceles spiders from 100 yr of Florida arachnological data. Medical personnel diagnosed 124 brown recluse spider bites from 31 of Florida's 67 counties in 6 yr. In contrast, only 11 finds of approximately 70 Loxosceles spiders have been made in 10 Florida counties in 100 yr. Florida does not have sufficient widespread populations of Loxosceles spiders to warrant consideration of brown recluse spider envenomation as a probable etiology of dermonecrosis. Florida health care would improve if medical personnel would consider the multitude of other etiologies that manifest in dermonecrosis.

Diagnoses of brown recluse spider bites (loxoscelism) greatly outnumber actual verifications of the spider in four western American states

We attempt to demonstrate that physicians overdiagnose loxoscelism (colloquially known as 'brown recluse spider bites') by comparing the numbers of such diagnoses to the historically known numbers of Loxosceles spiders from the same areas in four western American states. The medical community from non-endemic Loxosceles areas often makes loxoscelism diagnoses solely on the basis of dermonecrotic lesions where Loxosceles spiders are rare or non-existent. If these diagnoses were correct then Loxosceles populations should be evident, specimens should readily be collected over the years and there should be a reasonable correlation between diagnoses and spider specimens. In 41 months of data collection, we were informed of 216 loxoscelism diagnoses from California, Oregon, Washington and Colorado. In contrast, from these four states, we can only find historical evidence of 35 brown recluse or Mediterranean recluse spiders. There is no consistency between localities of known Loxosceles populations and loxoscelism diagnoses. There are many conditions of diverse etiology that manifest in dermonecrosis. In the western United States, physician familiarity with these conditions will lead to more accurate diagnoses and subsequent proper remedy.