Suspected brown recluse envenomation: a case report and review of different treatment modalities.

BACKGROUND: The Loxosceles reclusa, commonly known as the brown recluse spider, is responsible for virtually all cases of spider bites leading to a significant necrosis. CASE REPORT: We report the case of a 72-year-old man who presented to the Emergency Department complaining of back pain, weakness, and diarrhea. The patient stated that he sustained a bug bite 1 week before presenting to the hospital. His wound was necrotizing in nature and after an exhaustive work-up, the most likely etiology was found to be envenomation by a brown recluse spider, Loxosceles reclusa. CONCLUSION: This is an endemic cause of a necrotizing wound bite in areas of the Midwestern and Southern United States, but it is rarely reported in the Northeast.