Necrotic Arachnidism: Brown Recluse Bites

  • Jerome Goddard
Part of the Infectious Disease book series (ID)


Brown recluse spiders are known for the necrotic skin lesions they may produce. However, there is frequent misdiagnosis of brown recluse bites due to similar dermonecrotic lesions resulting from other conditions such as impetigo, decubitus ulcers, staph infections, ecthyma gangrenosum, and the like. This chapter presents facts and fables about brown recluse spiders, their bite reactions, and various treatment and control strategies.


Spider bites Brown recluse spiders Biology Distribution Bite reactions Dermonecrotic lesions Differential diagnosis Prevention Treatment Control 


  1. 1.
    Lane RP, Crosskey RW. Medical insects and arachnids. New York: Chapman and Hall; 1996. p. 723.Google Scholar
  2. 2.
    Goddard J. Physician’s guide to arthropods of medical importance. 6th ed. Boca Raton: Taylor and Francis (CRC); 2013. p. 412.Google Scholar
  3. 3.
    Russell FE, Waldron WG, Madon MB. Bites by the brown spiders Loxosceles unicolor and Loxosceles arizonica in California and Arizona. Toxicon. 1969;7:109–17.CrossRefGoogle Scholar
  4. 4.
    Lessenden CM, Zimmer LK. Brown spider bites. J Kans Med Soc. 1960;61:379–85.Google Scholar
  5. 5.
    Russell FE, Wainsschel J, Gertsch WJ. Bites of spiders and other arthropods. In: Conn HF, editor. Current therapy. Philadelphia: W.B. Saunders; 1973. p. 868.Google Scholar
  6. 6.
    Hostetler MA, Dribben W, Wilson DB, Grossman WJ. Sudden unexplained hemolysis occurring in an infant due to presumed Loxosceles envenomation. J Emerg Med. 2003;25:277–82.CrossRefGoogle Scholar
  7. 7.
    Leung LK, Davis R. Life-threatening hemolysis following a brown recluse spider bite. J Tenn Med Assoc. 1995;32:396–7.Google Scholar
  8. 8.
    Murray LM, Seger DL. Hemolytic anemia following a presumptive brown recluse spider bite. Clin Toxicol. 1994;32:451–6.Google Scholar
  9. 9.
    CDC. Necrotic arachnidism -- Pacific northwest, 1988-1996. CDC. MMWR. 1996;45:433–6.Google Scholar
  10. 10.
    Hite JM, Gladney WJ, Lancaster JLJ, Whitcomb WH. Biology of the brown recluse spider. Fayetteville: University of Arkansas Agricultural Experiment Station. Bull. No. 711; 1966.Google Scholar
  11. 11.
    O'Neil ME, Mack KA, Gilchrist J. Epidemiology of non-canine bite and sting injuries treated in U.S. emergency departments, 2001-2004. Pub Health Rep. 2007;122:764–75.CrossRefGoogle Scholar
  12. 12.
    Sandlin N. Convenient culprit: myths surround the brown recluse spider. (e-news for America's physicians). Chicago: American Medical Association. Accessed 5 Aug 2002.
  13. 13.
    Vetter RS, Bush SP. The diagnosis of brown recluse spider bite is overused for dermonecrotic wounds of uncertain etiology. Ann Emerg Med. 2002;39:544–6.CrossRefGoogle Scholar
  14. 14.
    Vetter RS, Cushing PE, Crawford RL, Royce LA. Diagnoses of brown recluse spider bites greatly outnumber actual verifications of the spider in four western American states. Toxicon. 2003;42:413–8.CrossRefGoogle Scholar
  15. 15.
    Vetter RS, Edwards GB, James LF. Reports of envenomation by brown recluse spiders outnumber verifications of Loxosceles spiders in Florida. J Med Entomol. 2004;41:593–7.CrossRefGoogle Scholar
  16. 16.
    Vetter RS, Barger DK. An infestation of 2,055 brown recluse spiders and no envenomation in a Kansas home: implications for bite diagnosis in nonendemic areas. J Med Entomol. 2002;39:948–51.CrossRefGoogle Scholar
  17. 17.
    Masters EJ, King LE Jr. Differentiating loxoscelism from Lyme disease. Emerg Med. 1994;26:47–9.Google Scholar
  18. 18.
    Cacy J, Mold JW. The clinical characteristics of brown recluse spider bites treated by family physicians. J Fam Pract. 1999;48:536–42.PubMedGoogle Scholar
  19. 19.
    Payne KS, Schilli K, Meier K, Rader RK, Dyer JA, Mold JW, et al. Extreme pain from brown recluse spider bites: model for cytokine-driven pain. JAMA Dermatol. 2014;150(11):1205–8.CrossRefGoogle Scholar
  20. 20.
    Gomez HF, Krywko DM, Stoecker WV. A new assay for the detection of Loxosceles species spider venom. Ann Emerg Med. 2002;39:469–74.CrossRefGoogle Scholar
  21. 21.
    Stoecker WV, Green JA, Gomez HF. Diagnosis of loxoscelism in a child confirmed with an enzyme-linked immunosorbent assay and noninvasive tissue sampling. J Am Acad Dermatol. 2006;55:888–90.CrossRefGoogle Scholar
  22. 22.
    Johnson JK, Khole T, Shurland S, Kereisel K, Stine OC, Roghmann MC. Skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus USA300 clone. Emerg Infect Dis. 2007;13:1195–9.CrossRefGoogle Scholar
  23. 23.
    King LE Jr, Rees RS. Dapsone treatment of a brown recluse bite. J Am Med Assoc. 1983;250:648.CrossRefGoogle Scholar
  24. 24.
    Masters EJ. Loxoscelism. N Engl J Med. 1998;339:379.CrossRefGoogle Scholar
  25. 25.
    Rees R, Campbell D, Rieger E, King LE. The diagnosis and treatment of brown recluse spider bites. Ann Emerg Med. 1987;16:945–9.CrossRefGoogle Scholar
  26. 26.
    Rees RS, Altenbern DP, Lynch JB, King LE Jr. Brown recluse spider bites: a comparison of early surgical excision versus dapsone and delayed surgical excision. Ann Surg. 1985;202:659–63.CrossRefGoogle Scholar
  27. 27.
    Merigian KS, Blaho K. Envenomation from the brown recluse spider: review of mechanism and treatment options. Am J Ther. 1996;3:724–34.CrossRefGoogle Scholar
  28. 28.
    Mold JW, Thompson DM. Management of brown recluse spider bites in primary care. J Am Board Fam Pract. 2004;17:347–52.CrossRefGoogle Scholar
  29. 29.
    Lowry BP, Bradfiled JF, Carroll RG. A controlled trial of topical nitroglycerin in a New Zealand white rabbit model of brown recluse spider envenomation. Ann Emerg Med. 2001;37:161–5.CrossRefGoogle Scholar
  30. 30.
    Escalante-Galindo P, Montoya-Cabrera MA, Terroba-Larios VM. Local dermonecrotic loxoscelism in children bitten by the spider Loxosceles reclusa [in Spanish]. Gac Med Mex. 1999;135:423–6.PubMedGoogle Scholar
  31. 31.
    Phillips S, Kohn M, Baker D, Vander Leest R, Gomez H, McKinney P, et al. Therapy of brown spider envenomation: a controlled trial of hyperbaric oxygen, dapsone, and cyproheptadine. Ann Emerg Med. 1995;25:363–8.CrossRefGoogle Scholar
  32. 32.
    Bope ET, Kellerman R. Conn’s current therapy. Philadelphia: Elsevier Saunders; 2017. p. 1375.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jerome Goddard
    • 1
  1. 1.Extension Professor of Medical EntomologyMississippi State UniversityMississippi StateUSA

Personalised recommendations