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Am J Trop Med Hyg. 2013 May 1; 88(5): 807–808.
PMCID: PMC3752741

A Case of Loxoscelism in Southern France

An 80-year-old man living in Fréjus in southern France had a cellulitis on the right arm (Figure 1). The patient had no fever, chills, systemic symptoms, or other clinical signs. He felt a slight pain in his arm during the night and while folding his arm, he crushed a spider. The spider's body was immediately recovered and then identified by an entomologist (Figure 2). This typical skin lesion and the spider identification defined this spider bite as an envenomation by a Loxosceles sp. spider.1 The outcome was good after only antalgic treatment.

Figure 1.
Skin reaction after a Loxosceles sp. spider bite, showing the red, white, and blue sign (arrows), day 0–13, southern France.
Figure 2.
A, Enlargement of the head and eyes of the spider in B. Identification of the genus Loxosceles was based on six eyes in a curved row on the upper part of the body (prosoma). The species L. rufescens can be suspected because of the geographic location ...

Infections with herpes zoster virus, herpes simplex virus, and Panton-Valentine toxin-positive Staphylococcus aureus can be misdiagnosed as necrotic arachnidism.1 Nevertheless, the characteristic red, white, and blue sign visible for the first few days (Figure 1) has been associated with loxoscelism. This sign is a consequence of erythema, ischemia, and thrombosis observed from the periphery to the center of the lesion. Loxosceles rufescens was suspected because it is endemic to Mediterranean regions (L. reclusa is not endemic to this region).2

ACKNOWLEDGMENTS

We thank Christine Rollard (Département de Systématique et Evolution, Unité de Taxonomie Collection, Section Arthropodes, Muséum National d'Histoire Naturelle, Paris, France) for help in identification of the spider.

Footnotes

Authors' addresses: Thomas Hubiche and Pascal del Giudice, Unité de Dermatologie–Infectiologie, Centre Hospitalier Intercommunal Fréjus Saint Raphaël, Fréjus, France, E-mails: hubiche-t/at/chi-frejus-saint-raphael.fr and del-giudice-p/at/chi-frejus-saint-raphael.fr. Pascal Delaunay, Service de Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France, and Institut National de la Santé et de la Recherche Médicale, Unite 895/Université de Nice-Sophia Antipolis, Nice, France, E-mail: delaunay.p/at/chu-nice.fr.

References

1. Swanson DL, Vetter RS. Bites of brown recluse spiders and suspected necrotic arachnidism. N Engl J Med. 2005;352:700–707. [PubMed]
2. Yigit N, Bayram A, Ulasoglu D, Danisman T, Corakocal I, Sabcak Z. Loxosceles spider bite in Turkey (Loxisceles rufescens, Sicariidae, Araneae) J Venom Anim Toxins Incl Trop Dis. 2008;14:178–187.

Articles from The American Journal of Tropical Medicine and Hygiene are provided here courtesy of The American Society of Tropical Medicine and Hygiene