Brown Recluse Spider Guide
The brown recluse spider (Loxosceles reclusa) exists in significant populations mainly in the midwestern United States. Although bites can cause significant harm, envenomation is infrequent, and cases are usually clinically insignificant. Proper knowledge of the spider's habitat and lifestyle as well as the signs and symptoms of loxoscelism are needed to assess clinical cases adequately. Loxoscelism can masquerade as many serious pathologies, and vice versa, so it is important for the clinician to explore all possibilities in the differential diagnosis thoroughly. Treatments are controversial, and no conclusive test for envenomation is currently available. This review provides information to help physicians, especially in nonendemic areas, include or exclude brown recluse bite in the clinical diagnosis and provide proper care.

The poisonous spider Loxosceles reclusa, more commonly known as the brown recluse spider, is the most dangerous and most prevalent Loxosceles species in the United States. The majority of wounds caused by the spider's bite do not require medical attention, but bites can cause a series of problems, most notably necrotic skin lesions. Unfortunately, the line between fact and fiction regarding the brown recluse spider seems to be rather hazy as applied to geographic distribution, identification, diagnosis, and treatment. Some authors think that the diagnosis of brown recluse spider bite is made too liberally in areas where populations are scarce at best. The sources of dermonecrotic lesions are extensive, and morbidity can be high if certain diseases are mistreated. In addition, treatment for severe brown recluse spider bites is still controversial, and medications have not been studied well and can have problematic side effects. The right amount of knowledge about the spider and the wounds it causes, however, can help the physician to diagnose correctly the often perplexing and complicated cases that brown recluse bites, or its mimics, can present.