Brown recluse spider bites in an urban wilderness

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.

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.

Reports of presumptive brown recluse spider bites reinforce improbable diagnosis in regions of North America where the spider is not endemic

Envenomations by the brown recluse spider have been reported throughout North America, despite the fact that the spider's range is limited to the South and central Midwest of the United States. Several of these medical reports have originated from regions of nonendemicity where the spider has never or rarely been documented and brown recluse spider populations are unknown. In most of these reports, no spider is positively identified in association with the dermonecrotic wound, and diagnosis has been based on clinical examination findings. Considering the extreme rarity of brown recluse spiders in areas of nonendemicity, the diagnosis of a presumptive bite is a misdiagnosis that reinforces the assumption that brown recluse spiders are common local etiologic agents of necrosis. There are many medical conditions of diverse origin that have been misdiagnosed as brown recluse spider bites, some of which can be fatal or debilitating. Physicians' awareness of these conditions will increase diagnostic accuracy in areas of North America where bites from brown recluse spiders are improbable.

A new assay for the detection of Loxosceles species (brown recluse) spider venom

STUDY OBJECTIVE

Dermal lesions from unrelated arthropod species and medical causes appear similar to Loxosceles species (brown recluse spider) bites. This may result in delayed diagnosis and treatment. We developed a sensitive Loxosceles species venom enzyme-linked immunosorbent assay (ELISA) and characterized the specificity of the assay by evaluating antigenic cross-reactivity from a variety of North American arthropod venoms.

METHODS

North American arthropod (14 spiders, 2 scorpions, and 1 bee) venoms were studied. Three venom amounts (diluted in 100 microL of ELISA buffer) were assayed: 16,000 ng, 2,000 ng, and 40 ng. The latter quantity was selected because this is the observed maximum amount of venom we detect when inoculating dermis with amounts likely to be deposited by a spider bite. The larger venom amounts are overwhelming quantities designed to test the limits of the assay for arthropod venom cross-reactivity. Similar amounts of Loxosceles species venom and bovine albumin served as positive and negative controls, respectively.

RESULTS

At the lowest amount of venom tested (40 ng), the ELISA detected only the Loxosceles species positive control. When 2,000 ng was assayed, only Scytodes fusca and Kukulcania hibernalis arachnid venoms (in addition to Loxosceles species) cross-reacted to the assay. Finally, at 16,000 ng, the ELISA assay modestly detected Diguetia canities, Heteropoda venatoria, Tegenaria agrestis, Plectreurys tristes, Dolomedes tenebrosus, and Hadrurus arizonensis arachnid venoms.

CONCLUSION

Cross-reactivity was observed in 8 of 17 North American arthropod venoms when large venom amounts were assayed with a Loxosceles species ELISA. By using a relevant quantity of venom, 40 ng, the assay was specific for Loxosceles species venom. The venom specificity of the ELISA may allow clinical application in Loxosceles species endemic regions of North America.