Emergency department death from systemic loxoscelism

Systemic loxoscelism is a constitutional illness resulting from the bite of the brown recluse spider. In severe form, it may cause hemolysis, acute renal failure, and disseminated intravascular coagulation. More rarely, it may result in death. We report an unusual case of systemic loxoscelism resulting in death less than one day following envenomation. We also discuss screening algorithms and contemporary management of systemic loxoscelism.