title: Rare case of dermonecrosis caused by a recluse spider bite in Europe.
abstract: Spider poisoning is rare in Europe, with very few reported cases in the literature. Recluse spider (genus Loxosceles) bites may lead to cutaneous and systemic manifestations known as loxoscelism. We report the second known case of spider bite poisoning in Malta caused by Loxosceles rufescens (Mediterranean recluse spider). A young adult female presented with localised erythema and pain on her left thigh after a witnessed spider bite. Over a few days, the area developed features of dermonecrosis together with systemic symptoms, including fever, fatigue and a generalised erythematous eruption. She was managed by a multidisciplinary team and the systemic symptoms resolved within 6 days, while the skin lesion healed with scarring within 2 months. A recluse spider bite should be considered in patients with dermonecrosis. Although spider bite poisoning is uncommon in Europe, it is important to diagnose and manage it appropriately since it could lead to potentially serious sequelae.
authors.affiliation: Department of Medicine, Mater Dei Hospital, Msida, Malta.
authors.forename: Monique
authors.initials: M
authors.lastname: Cachia
authors.affiliation: Department of Dermatovenerology, Sir Paul Boffa Hospital, Floriana, Malta.
authors.forename: Liam
authors.initials: L
authors.lastname: Mercieca
authors.affiliation: Department of Infectious Disease, Mater Dei Hospital, Msida, Malta.
authors.forename: Charles
authors.initials: C
authors.lastname: Mallia Azzopardi
authors.affiliation: Department of Dermatovenerology, Sir Paul Boffa Hospital, Floriana, Malta.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Boffa
mesh_terms: D000328:Adult; D000818:Animals; D063287:Brown Recluse Spider; D002921:Cicatrix / Q000209:etiology* / Q000473:pathology; D005060:Europe; D005260:Female; D006801:Humans; D009336:Necrosis; D012867:Skin / Q000473:pathology*; D001098:Spider Bites / Q000150:complications* / Q000473:pathology; D055815:Young Adult