# Fatal Viscerocutaneous Brown Recluse Envenomation With Orbital Compartment Syndrome

## TL;DR

A 44-year-old man died from a rare severe reaction to a brown recluse spider bite, which caused life-threatening eye and systemic complications.

## Contribution

This case report highlights a rare fatal outcome of brown recluse envenomation with orbital compartment syndrome.

## Key findings

- The patient developed fatal systemic loxoscelism following a brown recluse spider bite.
- Orbital compartment syndrome required emergency surgical intervention.
- The case underscores the potential severity and rapid progression of brown recluse envenomation.

## Abstract

Loxosceles is an arachnid genus comprising several species in the United States, popularly known as brown recluse spiders. The venom is cytotoxic, complex, and has a mixture of many proteins, some of which function as proteases. Envenomation can cause necrotic skin lesions that may become extensive and take many months to heal. Even more rarely, venom may cause systemic effects, leading to widespread hemolysis, coagulopathy, and death. These symptoms typically occur rapidly within 24-48 hours following the bite. We describe a rare case of a 44-year-old male with fatal systemic loxoscelism with orbital compartment syndrome requiring emergent lateral canthotomy and cantholysis.