Brown recluse spider envenomation

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

The bite of the BRS continues to pose a diagnostic and therapeutic challenge. The animal data reveal sphingomyelinase D to be the most important portion of venom and implicate serum factors (such as complement, C reactive protein, and leukocytes) as important cofactors for producing disease. Diagnosis remains difficult at best, with no easily available test to ensure a lesion is attributable to the bite of a BRS. Misdiagnosis of other treatable causes of necrotic skin lesions as BRS bites has presented a challenge also. Treatment of a confirmed brown recluse bite primarily is supportive with appropriate wound care. Animal studies and the few confirmed human cases have documented that the bite of the brown recluse is much less common than the medical and scientific communities have believed. The data also demonstrate that the bite of the recluse more often than not causes a mild wound, although it can produce a necrotic lesion. There also is support for the rare occurrence of hemolysis. Death reports involving L reclusa remain circumstantial. In recent years, Vetter and colleagues [5,116,117] repeatedly have underscored the need for confirmed bites as the evidential basis for our understanding of the spider and its medical significance. Given more than a century of questionable case reports, the medical community must limit BRS envenomation data to well-documented cases and not use the endpoint (ie, lesion or condition) to establish a cause retrospectively.

Original languageEnglish (US)
Pages (from-to)211-226
Number of pages16
JournalClinics in Laboratory Medicine
Volume26
Issue number1
DOIs
StatePublished - Mar 2006

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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