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Images in clinical practice
Mediterranean recluse spider bite as a military challenge calling for awareness
  1. Andreas S Papazoglou,
  2. P Panagopoulos,
  3. V Achimastos,
  4. M Konstantinou and
  5. E Fradelos
  1. Naval Hospital of Athens, Athens, Greece
  1. Correspondence to Dr Andreas S Papazoglou, Naval Hospital of Athens, Athens, Greece; anpapazoglou{at}yahoo.com

https://doi.org/10.1136/military-2022-002178

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    Military service personnel are usually exposed to conditions of increased risk of spider envenomation. Spiders of the genus Loxosceles (brown recluse spiders, BRS) are well known because their sphingomyelinase-D-containing venom could result in potentially threatening medical conditions (‘loxoscelism’: extensive skin necrosis, haematological abnormalities, renal failure).1 Nonetheless, the definitive diagnosis of a BRS bite is still challenging and usually presumptive based on clinician’s suspicion and epidemiological data.

    Herein, we present the case of a previously healthy 39-year-old active-duty service member presenting to the emergency department (ED) of a tertiary hospital in March 2022 with a seven-day history of a painful wound in his prepuce following the bite of a brown spider, which was later identified to be a Mediterranean BRS (MBRS).

    Within the first hours after the MBRS bite, the patient was administered intravenous analgesics for pain management in a primary healthcare department. He was also advised to receive topical antihistamine and fusidic acid/betamethasone creams as …

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    Footnotes

    • Contributors ASP, PP, VA and MK drafted the manuscript. EF supervised and critically revised the manuscript. All authors have approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.