Watch the spider!
M Cachia, L Mercieca, *C Mallia Azzopardi, M J Boffa; Department of Dermatology, Sir Paul Boffa Hospital, Malta &*Division of Infectious Diseases, Department of Internal Medicine, Mater Dei Hospital, Malta
Spider bite poisoning is a relatively uncommon occurrence in Europe. In Malta two spiders, namely Steatoda paykulliana and Loxosceles rufescens, are known to have poisonous venom. The former only causes mild localized pain and no known cases were recorded in Malta while the latter can cause potentially serious localized and systemic features called loxoscelism. Presentation may vary from mild discomfort to severe pain, skin necrosis and systemic features. We report the second known case of spider poisoning in Malta caused by Loxosceles rufescens. A young female presented with localized pain and erythema on her left thigh following a witnessed spider bite. Local features progressed to dermonecrosis while systemic features including fever, fatigue and generalized erythematous eruption lasted for 6 days. The patient was managed by a multidisciplinary team and the area healed with scarring over 2 months. Despite being a rare occurrence, clinicians should be aware of spider bite poisoning and its presentation as it could lead to potentially serious complications.