title: Suspected brown recluse envenomation: a case report and review of different treatment modalities.
abstract: BACKGROUND
  The Loxosceles reclusa, commonly known as the brown recluse spider, is responsible for virtually all cases of spider bites leading to a significant necrosis.
  
  
  METHODS
  We report the case of a 72-year-old man who presented to the Emergency Department complaining of back pain, weakness, and diarrhea. The patient stated that he sustained a bug bite 1 week before presenting to the hospital. His wound was necrotizing in nature and after an exhaustive work-up, the most likely etiology was found to be envenomation by a brown recluse spider, Loxosceles reclusa.
  
  
  CONCLUSIONS
  This is an endemic cause of a necrotizing wound bite in areas of the Midwestern and Southern United States, but it is rarely reported in the Northeast.
authors.affiliation: Department of Emergency Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, New York, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Andersen
authors.forename: Jennifer
authors.initials: J
authors.lastname: Campoli
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Johar
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Schumacher
authors.forename: E Jackson
authors.initials: EJ
authors.lastname: Allison
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use; D004565:Electroconvulsive Therapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D009336:Necrosis / Q000139:chemically induced; D005996:Nitroglycerin / Q000627:therapeutic use; D010727:Phosphoric Diester Hydrolases / Q000506:poisoning*; D001098:Spider Bites / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D013111:Spider Venoms / Q000506:poisoning*; D016896:Treatment Outcome; D014481:United States; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D013111:Spider Venoms; D014665:Vasodilator Agents; C055161:loxosceles venom; D003622:Dapsone; D010727:Phosphoric Diester Hydrolases; D005996:Nitroglycerin