Documented cutaneous loxoscelism in the south of France: an unrecognized condition causing delay in diagnosis

Abstract

Loxosceles bites are usually painless and rarely noticed by patients, often leading to a presumptive diagnosis. Therefore, in the case of a dermonecrotic lesion developing unfavourably with antibiotics, cutaneous loxoscelism should be one of the diagnoses to be considered.

Rare case of dermonecrosis caused by a recluse spider bite in Europe

“…A MEDLINE search of the word ‘Recluse spider’ revealed several case reports of Loxosceles reclusa bites in North and South America, but few from the Mediterranean where L. rufescens is the culprit species 4. These case reports were documented in Italy, Spain, Portugal, France, Turkey, Greece and Israel 1 5–13 . L. rufescens has also been reported from Balearic Islands, Corsica, Crete, Croatia and the Netherlands 14…”

Ultrasonography for early detection of non‐infectious necrotizing fasciitis secondary to cutaneous loxoscelism

“…1,2 Cutaneous loxoscelism (CL) is a form of spider bite poisoning, caused by necrotizing venom-producing Loxosceles spp, that typically courses with dermonecrosis. [3][4][5] In Mediterranean Europe, CL is produced by Loxosceles rufescens and is probably underdiagnosed. 3 A 50-year-old woman consulted to the emergency department for painful erythematous swelling on her forearm hours after a spider bite.…”

“…[3][4][5] In Mediterranean Europe, CL is produced by Loxosceles rufescens and is probably underdiagnosed. 3 A 50-year-old woman consulted to the emergency department for painful erythematous swelling on her forearm hours after a spider bite. The patient had spent the evening cleaning the outside of her home, located in the periphery of an urban area, next to a ravine, on the western Mediterranean Basin, when she identified a spider on the dorsum of her forearm.…”

“…9 The L. rufescens spider is endemic on the European Mediterranean basin, where it can be found in both rural and urban areas and where it is known to produce CL. 3,5,9 Clinical presentation of CL typically occurs several hours after the bite as a necrotic plaque with black, blueish-grey, pale and violaceous hues, that progresses despite treatment. 3,5 It may also present an excentric puncture sign.…”

“…3,5,9 Clinical presentation of CL typically occurs several hours after the bite as a necrotic plaque with black, blueish-grey, pale and violaceous hues, that progresses despite treatment. 3,5 It may also present an excentric puncture sign. Our case was consistent with these clinical features.…”