@article{ref1,
title="Brown Recluse Spider Bite to the Leg",
journal="Injury extra",
year="2006",
author="Bhatti, Asif Zubair and Adeniran, A. and Salam, S. and Naveed, M.A. and Phillips, Andrew",
volume="37",
number="2",
pages="45-48",
abstract="The Brown recluse (L. reclusus) is the best-known species of spiders belonging to the genus Loxosceles. Although found throughout North, Central and South America Loxosceles spiders in the United States are most prevalent in southern and central states including Arkansas, Oklahoma, Missouri and Kansas. These spiders are some of the most easily identified because of their characteristic markings. Commonly referred to as &quot;fiddle back&quot; spiders, they possess a dark, violin-shaped marking on the cephalothorax. The Brown recluse is known not only for its unique appearance but feared because of its bite. Research has identified specific components of the spider's venom responsible for the pathophysiologic features of the bite. In 1978, Forrester et al. identified sphingomyelinase D as the component that causes haemolysis. This factor is thought to be involved in both cutaneous and systemic reactions. Patel et al. later proposed a possible sequence that accounts for the dermo-necrosis. The venom first activates vascular endothelium inducing the expression of E-selectin and causing release of interleukin-8 and granulocyte macrophage colony-stimulating factor. These two cytokines are key mediators in the attraction and activation of neutrophils. As soon as they are present, the neutrophils bind to E-selectin, degranulate and cause tissue destruction.   <p>Language: en</p>",
language="en",
issn="1572-3461",
doi="10.1016/j.injury.2005.07.009",
url="http://dx.doi.org/10.1016/j.injury.2005.07.009"
}