A 24-year-old man was sleeping in bed wearing shorts when he felt a pinch on his left hip. He discovered a spider near the site of the bite. He preserved the spider and brought it to an entomologist who positively identified it as a brown recluse (loxosceles reclusa). The patient sought medical attention 4 days after the bite when pain increased and the lesion worsened. This view shows the location of the lesion. The patient was started on antibiotics and given a tetanus booster.
There was central ulceration with a wide area of surrounding erythema, most pronounced around the central lesion. There was tender swelling and fluctuance evident.
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A close-up of the central lesion is shown. The patient was febrile with an elevated white count. A diagnosis of secondary infection with abscess was made, and the patient was taken to the operating room for drainage and debridement. A large amount of pus was evacuated.
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