Question: What are the systemic effects that have been attributed to envenomation by the brown recluse spider?
Answer: The cited reference notes “Envenomation effects vary depending on the amount of venom injected, anatomic location of the bite, the inclusion of gastric contents within the bite, host susceptibility, and concomitant illness.” These authors further point out that “Twenty-four to 72 hours after envenomation, a morbilliform rash, fever, chills, nausea, vomiting, malaise, arthralgia, and myalgia may occur. Hemolytic anemia, leukocytosis, and thrombocytopenia are characteristic hematologic abnormalities. Very rarely, disseminated intravascular coagulation occurs.” Finally the cited article reports: “Systemic effects are more common in children and may be severe.” (Sams HH et al. Nineteen documents cases of Loxosceles reclusa envenomation. 2001 J Am Acad Dermatol 44:603-8.)