What is the common presentation of the Loxosceles reclusa (brown recluse spider) bite?
According to the cited source, “the bite is usually innocuous and may initially go unnoticed. The spectrum of reaction ranges from minor local reaction to severe necrotic arachnidism. The local reaction consists of mild to moderate pain 2-8 hours after the bite, with erythema and a central blister or pustule. Within 24 hours, there is a subcutaneous discoloration that spreads over 3 to 4 days, reaching size of 10 to 15 cm. At this time, the pustule drains, producing an ulcerated “crater.”
Stoecker WV, Vetter RS, Dyer JA. NOT RECLUSE—A Mnemonic Device to Avoid False Diagnoses of Brown Recluse Spider Bites. JAMA Dermatol. 2017;153(5):377–378. doi:10.1001/jamadermatol.2016.5665
Contributed by Zach Panzer, MD, Pediatric Emergency Medicine Fellow at Nationwide Children’s Hospital, Columbus, Ohio