title: Tularemia presenting as suspected necrotic arachnidism.
abstract: The true danger of the spider bite stems from misdiagnosis and resultant delay in proper treatment of entities that, unlike spider bites, are not self-limited. Obtaining a complete exposure and travel history is central to the development of an accurate and appropriate differential diagnosis.
authors.affiliation: Division of General Internal Medicine Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.
authors.forename: Heather F
authors.identifier: 0000-0001-8591-938X
authors.initials: HF
authors.lastname: Sateia
authors.affiliation: Division of Infectious Disease Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Melia
authors.affiliation: Division of General Internal Medicine Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cofrancesco
keywords: Arachnidism; necrotic skin lesion; spider bite; splenomegaly; tick bite; tularemia