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Brown Recluse Spider Envenomation

      Willis Caveness [
      • Caveness W.
      Insect bite complicated by fever.
      ] is credited with the first account of toxicity from Loxosceles reclusa in 1872 involving a Tennessee man with fever following an insect bite. It was not until 1929 that Schmaus [
      • Schmaus L.
      Case of arachnoidism (spider bite).
      ] described skin injury associated with the bite. In 1957, Atkins and colleagues [
      • Atkins J.
      • Wingo C.
      • Sodeman W.
      Probable cause of necrotic spider bite in the midwest.
      ] proposed that the bite of L reclusa caused skin necrosis similar to that of its South American relative L laeta. “…[I]t is not unduly presumptive tentatively to assign to L reclusus the same relationship with cutaneous arachnoidism [sic] in Missouri that L laeta bears to that condition in South America” [
      • Atkins J.
      • Wingo C.
      • Sodeman W.
      Probable cause of necrotic spider bite in the midwest.
      ]. From the beginning, the diagnosis of brown recluse spider bite was based on supposition much more than fact.
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