Necrotizing anachronism from loxosceles spider bite: a case report and review of literature

Abstract

Commonly, simple cutaneous lesions are seen after spider bites, especially with loxosceles species. However, systemic findings of nausea, vomiting, arthralgia, hemolysis, thrombocytopenia, renal failure and DIC rarely occur after spider bites. Loxoscelism defined as the combined presentation cutaneous and systemic findings together. ’The cutaneous lesion which is usually asymptomatic emerges as an erythematous may progress to ulceration and necrosis leading to amputation, loss of extremity function and eschar formation. It is essential to consider the diagnosis of loxoscelism in the differential diagnosis of insect bites in order to arrange close follow-up and minimize the local and systemic complications. In this study we present a patient who was treated in the emergency department with a erythematous cutaneous lesion which progressed to necrosis in a 2-3 week period and required surgical debridment. We also review the literature of spider bites and their treatment in the emergency department.