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Brown recluse spider

Scientific classification
Kingdom: Animalia
Phylum: Arthropoda
Class: Arachnida
Order: Araneae
Family: Sicariidae
Genus: Loxosceles
Species: L. Arthropods are Animals belonging to the Phylum Arthropoda (from Greek ἄρθρον arthron, " Joint " Arachnids are a class ( Arachnida) of joint-legged Invertebrate Animals in the subphylum Chelicerata. Spiders are Predatory Invertebrate Animals that have two body segments, eight legs no chewing mouth parts and no wings The spider family Sicariidae is a family of venomous Spiders known for their Necrotic venom The recluse spiders (genus Loxosceles) also known as fiddle-back or violin spiders, are a venomous genus of spiders known for reclusa
Binomial name
Loxosceles reclusa
Gertsch & Mulaik, 1940

The brown recluse spider, Loxosceles reclusa, is a well-known member of the family Sicariidae (formerly placed in a family "Loxoscelidae"). Willis John Gertsch (1906 - 1998 was an Entomologist specialising in Arachnology. Spiders are Predatory Invertebrate Animals that have two body segments, eight legs no chewing mouth parts and no wings The spider family Sicariidae is a family of venomous Spiders known for their Necrotic venom It is usually between 6–20 mm (¼ in and ¾ in) but may grow larger. The Millimetre ( American spelling: millimeter, symbol mm) is a unit of Length in the Metric system, equal to Inches redirects here To see the Les Savy Fav album see Inches. It is brown and sometimes an almost deep yellow color and usually has markings on the dorsal side of its cephalothorax, with a black line coming from it that looks like a violin with the neck of the violin pointing to the rear of the spider, resulting in the nicknames fiddleback spider, brown fiddler or violin spider. In Anatomy, the dorsum is the upper side of animals that typically run fly or swim in a horizontal position and the back side of animals (like humans that walk upright The cephalothorax (call prosoma in some groups is an anatomical term used in Arachnids and Malacostracan Crustaceans for the The violin is a bowed String instrument with four strings usually tuned in Perfect fifths It is the smallest and highest-pitched member Coloring varies from light tan to brown and the violin marking may not be visible.

Contents

Description

Since the "violin pattern" is not diagnostic, and other spiders may have similar marking (i. e. cellar spiders and pirate spiders), for purposes of identification it is far more important to examine the eyes. The Pholcidae are a Spider family in the suborder Araneomorphae. The family Mimetidae, commonly called pirate spiders, are Spiders which typically feed on other spiders Differing from most spiders, which have eight eyes, recluse spiders have six eyes arranged in pairs (dyads) with one median pair and two lateral pairs. In Probability theory and Statistics, a median is described as the number separating the higher half of a sample a population or a Probability distribution Human anatomical terms make up a distinct nomenclature to describe areas of the body to provide orientation when describing parts of Human anatomy, and to Only a few other spiders have 3 pairs of eyes arranged this way (e. g. , scytodids), and recluses can be distinguished from these as recluse abdomens have no coloration pattern nor do their legs, which also lack spines. Spitting spiders (family Scytodidae) are Spiders of the Genus Scytodes and their relatives [1]

Habitat

Recluse spiders build irregular webs that frequently include a shelter consisting of disorderly threads. These spiders frequently build their webs in woodpiles and sheds, closets, garages, cellars and other places that are dry and generally undisturbed. They seem to favor cardboard when dwelling in human residences, possibly because it mimics the rotting tree bark which they naturally inhabit. They also go in shoes, inside dressers, in bed sheets of infrequently used beds, in stacks of clothes, behind baseboards, behind pictures and near furnaces. The common source of human-recluse contact is during the cleaning of these spaces, when their isolated spaces suddenly are disturbed and the spider feels threatened. Unlike most web weavers, they leave these webs at night to hunt. Males will move around more when hunting while females don't usually stray far from their web.

Distribution

The brown recluse spider is native to the United States from the southern Midwest south to the Gulf of Mexico. The United States of America —commonly referred to as the The Gulf of Mexico ( Spanish: Golfo de México) is the ninth largest Body of water in the world [2] The native range lies roughly south of a line from southeastern Nebraska through southern Iowa, Illinois, and Indiana to southwestern Ohio. Nebraska ( is a state located on the Great Plains of the Midwestern United States and The State of Iowa ( is a state in the Midwestern region of the United States of America. The State of Illinois ( roughly ill-i-NOY is a state of the United States of America, the 21st to be admitted to the Union. The State of Indiana ( was the 19th US state admitted into the union Ohio ( is a Midwestern state of the United States. As part of the Great Lakes region, Ohio has long been a cultural and geographical crossroads In the southern states, it is native from central Texas to western Georgia. Texas ( is a state geographically located in the South Central United States and is also known as the Lone Star State. The State of Georgia ( is a state in the United States and was one of the original Thirteen Colonies that revolted against British rule They are generally not found west of the Rocky Mountains. Mountain peaks of the Rocky Mountains The Rocky Mountains, often called the Rockies, are a Mountain range in western North America. [3] A related species, the brown violin spider (Loxosceles rufescens), is found in Hawaii. The State of Hawaii ( or həˈwaɪʔiː Hawaiian: Mokuāina o Hawaii) is a state in the United States located on an Archipelago in the [4] Despite many rumors to the contrary, the brown recluse spider has not established itself in California, nor Canada. [5] There are other species of Loxosceles native to the southwestern part of the United States, including California, that may resemble the brown recluse, but these species have never been documented as medically significant. The recluse spiders (genus Loxosceles) also known as fiddle-back or violin spiders, are a venomous genus of spiders known for

Venomous bite

Brown recluse compared to the size of a USA quarter
Brown recluse compared to the size of a USA quarter

As indicated by its name, this spider is not aggressive and usually bites only when pressed against the skin, such as when tangled up within clothes, bath towels, or in bedding. A quarter dollar is a coin worth 1/4 of a United States dollar, or 25 cents. A recluse is someone in isolation who hides away from the attention of the public a person who lives in Solitude, i [6] In fact, many wounds that are necrotic and diagnosed as brown recluse bites can actually be Methicillin-resistant Staphylococcus aureus (MRSA). [6] Actual brown recluse bites are rare. Brown recluse bites may produce a range of symptoms known as loxoscelism. A condition produced by the bite of the Brown recluse spider of North America and characterized by a gangrenous slough at the site of bite nausea malaise fever Hemolysis There are two types of loxoscelism: cutaneous (skin) and systemic (viscerocutaneous). The skin is the outer covering of living tissue of an animal (or plant

Most bites are minor with no necrosis. Necrosis (in Greek Νεκρός = "dead" is the name given to unnatural Death of cells and living tissue. However, a small number of bites produce severe dermonecrotic lesions, and, sometimes, severe systemic symptoms, including organ damage. Rarely, the bite may also produce a systemic condition with occasional fatalities. Most fatalities are in children under 7 [7] or those with a weaker than normal immune system. (For a comparison of the toxicity of several kinds of spider bites, see the list of spiders having medically significant venom. '''Spiders''' occasionally bite humans Although 98-99% of spider bites are harmless more rarely the symptoms of their bites can include necrotic wounds systemic )

A minority of brown recluse spider bites form a necrotizing ulcer that destroys soft tissue and may take months to heal, leaving deep scars. Ulcers are healing wounds that develop on the skin mucous membranes or eye Scars (also called cicatrices) are areas of fibrous tissue that replace normal Skin (or other tissue after injury The damaged tissue will become gangrenous and eventually slough away. Please do not add warnings to this page about the pictures Wikipedia is not censored for taste and has a guideline preventing such warnings - WikipediaNo disclaimers in articles The initial bite frequently cannot be felt and there may be no pain, but over time the wound may grow to as large as 10 inches (25 cm) in extreme cases. Bites usually become painful and itchy within 2 to 8 hours, pain and other local effects worsen 12 to 36 hours after the bite with the necrosis developing over the next few days. [8]

Serious systemic effects may occur before this time, as the venom spreads throughout the body in minutes. Mild symptoms include nausea, vomiting, fever, rashes, and muscle and joint pain. Nausea ( Latin: Nausea, Greek:, " Sea-sickness " also called wamble) is the sensation of unease and discomfort Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris A rash is a change of the Skin which affects its color appearance or Texture. Rarely more severe symptoms occur including hemolysis, thrombocytopenia, and disseminated intravascular coagulation. Hemolysis (or haemolysis)—from the Greek Hemo-, Greek meaning blood - Lysis, meaning to break open—is the breaking Thrombocytopenia (or -paenia, or thrombopenia in short is the presence of relatively few Platelets in Blood. Disseminated intravascular coagulation ( DIC) also known as consumptive coagulopathy, is a pathological activation of Coagulation (blood clotting mechanisms [9] Debilitated patients, the elderly, and children may be more susceptible to systemic loxoscelism. Deaths have been reported for both the brown recluse and the related South American species L. laeta[10] and L. intermedia. Other recluse species such as the desert recluse (found in the desert southwestern United States) are reported to have caused necrotic bite wounds, though only rarely[11].

Numerous other spiders have been associated with necrotic bites in the medical literature. A partial list includes the hobo spider and the yellow sac spiders. The hobo spider ( Tegenaria agrestis) is a member of the genus of Spiders known colloquially as funnel web spiders Cheiracanthium is a genus of spiders in the Miturgidae family However, the bites from these spiders are not known to produce the severe symptoms that often follow from a recluse spider bite, and the level of danger posed by each has been called into question. [12][13] So far, no known necrotoxins have been isolated from the venom of any of these spiders, and some arachnologists have disputed the accuracy of many spider identifications carried out by bite victims, family members, medical responders, and other non-experts in arachnology. There have been several studies questioning danger posed by some of these spiders. In these studies, scientists examined case studies of bites in which the spider in question was positively identified by an expert, and found that the incidence of necrotic injury diminished significantly when "questionable" identifications were excluded from the sample set. [14][15]

Bite treatment

First aid involves the application of an ice pack to control inflammation, the application of aloe vera to soothe and help control the pain, and prompt medical care. Inflammation ( Latin, inflamatio, to set on fire is the complex biological response of vascular tissues to harmful stimuli such as Pathogens If it can be easily captured, the spider should be brought with the patient in a clear, tightly closed container so it may be identified. However, by the time the bite is noticed any spider found nearby is not likely to be the culprit.

There is no established treatment for necrosis. Necrosis (in Greek Νεκρός = "dead" is the name given to unnatural Death of cells and living tissue. Routine treatment should include elevation and immobilization of the affected limb, application of ice, local wound care, and tetanus prophylaxis. Many other therapies have been used with varying degrees of success including hyperbaric oxygen, dapsone, antihistamines (e. Hyperbaric medicine, also known as hyperbaric oxygen therapy (HBOT is the medical use of Oxygen at a higher than Atmospheric pressure. Dapsone (diamino-diphenyl sulfone is an pharmacological Medication most commonly used in combination with Rifampicin and Clofazimine as multidrug g. , cyproheptadine), antibiotics, dextran, glucocorticoids, vasodilators, heparin, nitroglycerin, electric shock, curettage, surgical excision, and antivenom. Cyproheptadine (usually as cyproheptadine hydrochloride, trade name Periactin) is an antihistaminic and Antiserotonergic agent In modern usage an antibiotic is a Chemotherapeutic agent with activity against Microorganisms such as Bacteria, fungi or Protozoa Dextran is a complex branched Glucan ( Polysaccharide) made of many Glucose molecules joined into chains of varying lengths (from 10 to 150 kilodaltons Glucocorticoids (GC are a class of Steroid hormones characterised by an ability to bind with the glucocorticoid receptor ( GR) and trigger similar effects Heparin, a highly-sulfated Glycosaminoglycan, is widely used as an injectable Anticoagulant and has the highest negative Charge density of any known Nitroglycerin ( NG) ( US spelling also known as nitroglycerine, ( UK Spelling trinitroglycerin, trinitroglycerine "Electrocute" redirects here For the band see Electrocute (band. Curettage, in Surgery, is the use of a Curette to remove tissue by scraping or scooping Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental Antivenin (or antivenom or antivenene) is a biological product used in the treatment of venomous bites or stings None of these treatments have been subjected to controlled, randomized trials to conclusively show benefit. In almost all cases, bites are self-limited and typically heal without any medical intervention. [3]

It is important to seek medical treatment if a brown recluse bite is suspected, as in the rare cases of necrosis the effects can quickly spread, particularly when the venom reaches a blood vessel. Cases of brown recluse venom traveling along a limb through a vein or artery are rare, but the resulting mortification of the tissue can affect an area as large as several inches, to the extreme of requiring excising of the wound. While it is possible, and even likely, that many cases of "brown recluse bites" are indeed misidentifications of other infections or envenomations, the brown recluse has justly earned its reputation.

Specific treatments

Dapsone is commonly used in the USA and Brazil for the treatment of necrosis. Dapsone (diamino-diphenyl sulfone is an pharmacological Medication most commonly used in combination with Rifampicin and Clofazimine as multidrug The United States of America —commonly referred to as the |utc_offset = -2 to -4 |time_zone_DST = BRST |utc_offset_DST = -2 to -5 |cctld There have been conflicting reports about its efficacy and some have suggested it should no longer be used routinely, if at all. [16]

Wound infection is rare. Antibiotics are not recommended unless there is a credible diagnosis of infection. [17]

Studies have shown surgical intervention is ineffective and may worsen outcome. Excision may delay wound healing, cause abscesses, and lead to objectional scarring. An abscess (abscessus is a collection of Pus (dead Neutrophils) that has accumulated in a cavity formed by the tissue on the basis of an infectious process [18]

Anecdotal evidence suggests benefit can be gained with the application of nitroglycerin patches. The expression anecdotal evidence has two quite distinct meanings [19] The brown recluse venom is a vasoconstrictor, and nitroglycerin causes vasodilation, allowing the venom to be diluted into the bloodstream, and fresh blood to flow to the wound. Theoretically this prevents necrosis, as vasoconstriction may contribute to necrosis. However, one scientific animal study found no benefit in preventing necrosis, with results showing it increased inflammation and it caused symptoms of systemic envenoming. The authors concluded the results of the study did not support the use of topical nitroglycerin in brown recluse envenoming. [20]

Antivenom, available in South America, appears to be the most promising therapy. However, antivenoms are most effective if given early and because of the painless bite patients do not often present until 24 or more hours after the event, possibly limiting the effect of this intervention. [21]

Misdiagnoses

It is estimated that 80% of reported brown recluse bites may be misdiagnosed. The misdiagnosis of a wound as a brown recluse bite could delay proper treatment of serious diseases. [3] There is now a ELISA-based test for brown recluse venom that can determine if a wound is a brown recluse bite, although it is not commercially available and not in routine use. Enzyme-Linked ImmunoSorbent Assay, also called ELISA, Enzyme ImmunoAssay or EIA, is a biochemical technique used mainly in Immunology [22][3]

There are numerous documented infectious and noninfectious conditions (including pyoderma gangrenosum, bacterial infections by Staphylococcus and Streptococcus, herpes, diabetic ulcer, fungal infections, chemical burns, toxicodendron dermatitis, squamous cell carcinoma, localized vasculitis, syphilis, toxic epidermal necrolysis, sporotrichosis, and Lyme disease) that produce wounds that have been initially misdiagnosed as recluse bites by medical professionals; many of these conditions are far more common and more likely to be the source of mysterious necrotic wounds, even in areas where recluses actually occur. Pyoderma gangrenosum is a disease that causes tissue to become necrotic, causing deep Ulcers that usually occur on the legs Staphylococcus (in Greek σταφυλη staphyle means bunch of grapes and κοκκος coccos means granule is a genus of Gram-positive Streptococcus is a Genus of spherical Gram-positive bacteria belonging to the phylum Firmicutes and the Herpes simplex is a Viral disease caused by Herpes simplex viruses both herpes simplex virus 1 (HSV-1 and herpes simplex virus 2 (HSV-2 cause herpes simplex Toxicodendron is a genus of woody Trees Shrubs and Vines in the Anacardiaceae or Sumac Family including poison ivy poison oak In Medicine, squamous cell carcinoma (SCC is a form of Cancer of the Carcinoma type that may occur in many different organs including the Skin Vasculitis (plural vasculitides) a group of diseases featuring Inflammation of the wall of Blood vessels including veins ( Phlebitis) arteries Syphilis is a Sexually transmitted disease caused by the spirochetal Bacterium Treponema pallidum pallidum. Toxic epidermal necrolysis (TEN also known as Lyell's syndrome, is a life-threatening dermatological condition that is frequently induced by a reaction to medications Sporotrichosis is a disease caused by the infection of the Fungus Sporothrix schenckii. Lyme disease, or borreliosis, is an Emerging infectious disease caused by at least three Species of Bacteria belonging to the Genus [3]

Reported cases of bites occur primarily in Arkansas, Texas, Kansas, Missouri, Colorado, and Oklahoma. Arkansas ( is a state located in the southern region of the United States. Texas ( is a state geographically located in the South Central United States and is also known as the Lone Star State. Kansas ( is a Midwestern state in the central region of the United States of America, an area often referred to as the American " Missouri ( or) is a state in the Midwestern region of the United States bordered by Iowa, Illinois, Kentucky, Tennessee The State of Colorado ( or chiefly by nonresidents) is a state located in the Rocky Mountain region of the United States of America. Oklahoma ( is a state located in the South Central region of the United States of America. There have been many reports of brown recluse bites in California (and elsewhere outside the range of the brown recluse); however the brown recluse is not found in California[23] (though a few related species may be found there, none of which has been shown to bite humans). California ( is a US state on the West Coast of the United States, along the Pacific Ocean. To date, the reports of bites from areas outside of the spider's native range have been either unverified, or - if verified - specimens moved by travelers or commerce. Gertsch and Ennik (1983) report that occasional spiders have been intercepted in various locations where they have no known established populations; Arizona, California, Colorado, Florida, Maine, Minnesota, New Jersey, Mexico, New York, North Carolina, Wyoming and Tamaulipas (Mexico),[24] which indicates that these spiders may indeed be transported fairly easily, though the lack of established populations well outside the natural range also indicates that such movement does not lead to colonization of new areas. The State of Arizona ( is a state located in the southwestern region of the United States. California ( is a US state on the West Coast of the United States, along the Pacific Ocean. The State of Colorado ( or chiefly by nonresidents) is a state located in the Rocky Mountain region of the United States of America. Florida ( is a state located in the southeastern region of the United States, bordering Alabama to the northwest and Georgia to the The State of Maine ( is a state in the New England region of the northeastern United States of America, bordering the Atlantic Ocean Minnesota ( Native Americans demonstrated the name to early settlers New Jersey ( is a state in the Mid-Atlantic and Northeastern regions of the United States. The United Mexican States ( or commonly Mexico (ˈmɛksɪkoʊ () is a federal constitutional Republic in North America. New York ( is a state in the Mid-Atlantic and Northeastern regions of the United States and is the nation's third most populous North Carolina ( is a state located on the Atlantic Seaboard in the southeastern United States The State of Wyoming ( is a sparsely populated state in the western region of the United States. Tamaulipas is one of the 31 states of Mexico, it is located in the northeast Many arachnologists believe that many bites attributed to the brown recluse in the West Coast are not spider bites at all, or possibly instead the bites of other spider species; for example, the bite of the hobo spider has been reported to produce similar symptoms, and is found in the northwestern United States and southern British Columbia in Canada. The " West Coast " " Western Seaboard " or " Pacific Seaboard " are terms for the westernmost coastal states of the Western United States The hobo spider ( Tegenaria agrestis) is a member of the genus of Spiders known colloquially as funnel web spiders The United States of America —commonly referred to as the British Columbia (ˌbrɪtɨʃ kəˈlʌmbiə ( BC) ( (la Colombie-Britannique C However, the toxicity of the hobo spider has been called into question as bites have not been proven to cause necrosis, and the spider is not considered a problem in its native Europe. [25] In addition, published work has shown that tick-induced Lyme disease rashes are often misidentified as brown recluse spider bites. Tick is the common name for the small Arachnids in Superfamily Ixodoidea that along with other Mites constitute the Acarina. Lyme disease, or borreliosis, is an Emerging infectious disease caused by at least three Species of Bacteria belonging to the Genus [26]

Footnotes

  1. ^ Vetter R (1999). "Identifying and misidentifying the brown recluse spider". Dermatol Online J 5 (2): 7. PMID 10673460.  
  2. ^ Jone SC. Ohio State University Fact Sheet: Brown Recluse Spider. Retrieved on 2006-09-02. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 44 BC - Pharaoh Cleopatra VII of Egypt declares her son co-ruler as Ptolemy XV Caesarion.
  3. ^ a b c d e Swanson D, Vetter R (2005). "Bites of brown recluse spiders and suspected necrotic arachnidism. ". N Engl J Med 352 (7): 700-7. doi:10.1056/NEJMra041184. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 15716564.  
  4. ^ Kuwaye, Todd T. . Case Based Pediatrics for Medical Students and Residents. Retrieved on 2006-12-10. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 1041 - Empress Zoe of Byzantium elevates her adoptive son to the throne of the Eastern Roman Empire as Michael V
  5. ^ Vetter, Rick. Myth of the Brown Recluse: Fact, Fear, and Loathing. Retrieved on 2008-05-02. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1194 - King Richard I of England gives Portsmouth its first Royal Charter.
  6. ^ a b Vetter R, Bush S (2002). "The diagnosis of brown recluse spider bite is overused for dermonecrotic wounds of uncertain etiology". Ann Emerg Med 39 (5): 544-6. doi:10.1067/mem.2002.123594. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 11973562.  
  7. ^ Tenn. Boy Ruled Killed by Spider Bite - MSNBC Wire Services - MSNBC.com
  8. ^ Wasserman G, Anderson P (1983-1984). "Loxoscelism and necrotic arachnidism". J Toxicol Clin Toxicol 21 (4-5): 451-72. PMID 6381752.  
  9. ^ Wasserman G (2005). "Bites of the brown recluse spider. ". N Engl J Med 352 (19): 2029-30; author reply 2029-30. PMID 15892198.  
  10. ^ http://bases.bireme.br/cgi-bin/wxislind.exe/iah/online/?IsisScript=iah/iah.xis&nextAction=lnk&base=MEDLINE_1966-1995&exprSearch=2577020&indexSearch=UI&lang=i Schenone H, Saavedra T, Rojas A, Villarroel F. "Loxoscelism in Chile. Epidemiologic, clinical and experimental studies". Revista do Instituto de Medicina Tropical de São Paulo 31:403-415, 1989
  11. ^ Vetter, R. S. (2008) Spiders of the genus Loxosceles (Araneae, Sicariidae): a review of biological, medical and psychological aspects regarding envenomations. The Journal of Arachnology 36:150–163
  12. ^ Bennett, R. G. and R. S. Vetter. (2004). "An approach to spider bites: erroneous attribution of dermonecrotic lesions to brown recluse and hobo spider bites in Canada". Canadian Fam Physician 50: 1098-1101.  
  13. ^ James H. Diaz, MD (2005). "Most necrotic ulcers are not spider bites". American Journal of Tropical Medicine and Hygiene 72 (4): 364-367.  
  14. ^ Ibister, Goeffrey K. and Gray, Michael R. "White-tail spider bite: a prospective study of 130 definite bites by Lampona species". Medical Journal of Australia 179 (4): 199-202.  
  15. ^ Isbister, Goeffrey K, Hirst D. (2003-08). "A prospective study of definite bites by spiders of the family Sparassidae (huntsmen spiders) with identification to species level". Toxicon 42 (2): 163-71.  
  16. ^ Bryant S, Pittman L (2003). "Dapsone use in Loxosceles reclusa envenomation: is there an indication?". Am J Emerg Med 21 (1): 89-90. doi:10.1053/ajem.2003.50021. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 12563594.  
  17. ^ Anderson P (1998). "Missouri brown recluse spider: a review and update". Mo Med 95 (7): 318-22. PMID 9666677.  
  18. ^ Rees R, Altenbern D, Lynch J, King L (1985). "Brown recluse spider bites. A comparison of early surgical excision versus dapsone and delayed surgical excision". Ann Surg 202 (5): 659-63. PMID 4051613.  
  19. ^ Burton K. The Brown Recluse Spider: Finally stopped in its tracks. Retrieved on 2006-09-02. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 44 BC - Pharaoh Cleopatra VII of Egypt declares her son co-ruler as Ptolemy XV Caesarion.
  20. ^ Lowry B, Bradfield J, Carroll R, Brewer K, Meggs W (2001). "A controlled trial of topical nitroglycerin in a New Zealand white rabbit model of brown recluse spider envenomation". Ann Emerg Med 37 (2): 161-5. doi:10.1067/mem.2001.113031. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 11174233.  
  21. ^ Isbister G, Graudins A, White J, Warrell D (2003). "Antivenom treatment in arachnidism". J Toxicol Clin Toxicol 41 (3): 291-300. PMID 12807312.  
  22. ^ Gomez H, Krywko D, Stoecker W (2002). "A new assay for the detection of Loxosceles species (brown recluse) spider venom". Ann Emerg Med 39 (5): 469-74. doi:10.1067/mem.2002.122914. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 11973553.  
  23. ^ Vetter R. Myth of the Brown Recluse: Fact, Fear, and Loathing. Retrieved on 2006-09-02. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 44 BC - Pharaoh Cleopatra VII of Egypt declares her son co-ruler as Ptolemy XV Caesarion.
  24. ^ [1] University of Florida Fact Sheet
  25. ^ Vetter R, Isbister G (2004). "Do hobo spider bites cause dermonecrotic injuries?". Ann Emerg Med 44 (6): 605-7. doi:10.1016/j.annemergmed.2004.03.016. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 15573036.  
  26. ^ Osterhoudt KC, Zaoutis T, Zorc JJ (2002). "Lyme disease masquerading as brown recluse spider bite". Annals of emergency medicine 39 (5): 558-61. doi:10.1067/mem.2002.119509. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 11973566.  

External links

Dictionary

brown recluse spider

-noun

  1. A venomous American spider, Loxosceles reclusa, that has a mark on its back in the shape of a violin.
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