Monday, June 6, 2011



A boy comes in with a bite while putting on a shirt, and the spider above is the culprit. He didn't think much of it at the time since it wasn't initially painful. But over the next few hours, he started having more and more pain. He also has malaise, nausea, fever, and myalgias.

Initially, the parents describe erythema with two cutaneous puncture wounds on the skin. Over time, it developed a central pallor, and now on exam 2 days later, you note a dark, depressed eschar. It looks almost necrotic, and the area has decreased sensation.

Challenge: Identify the spider.

Image shown under Creative Commons Attribute Share-Alike License, from Wikipedia.


jimmy said...

brown recluse-"fiddle back"

Michelle said...

brown recluse?

Craig Chen said...

yes! these things terrify me. nice identification of them!

This is a brown recluse spider bite.

Source: UpToDate.