Septic arthritis attributed to a spider bite - a case report and review of the literature

Individuals who travel to tropical or subtropical areas are exposed to various infectious, environ-mental, and climatic risk factors, as well as traffic accidents, security problems, natural disasters, and direct contact with potentially dangerous plants or animals. Accidental bites by venomous spiders during long journeys are always dangerous to health and life, but it is not usually recognized that nonvenomous spiders also pose such a substantial threat to the lives of local inhabitants and travelers. Here, we present an unusual case of a 41-year-old male patient who was admitted to the University Hospital after a tourist trip to Kenya with skin lesions and abscesses located in the gluteal region and the lower limb, caused by a tropical spider bite. As a severe complication, the patient developed sepsis and septic arthritis of the hip, contralateral to the primary skin lesions. Microbiological evalua-tion of peripheral blood, synovial fluid, and pus from subcutaneous abscesses consistently identified methicillin-sensitive Staphylococcus aureus (MSSA) as the cause of sepsis. This case is unusual and exceptional, as it illustrates the possibility of a serious complication in the form of generalized bacterial superinfection accompanying a spider bite in an immunocompetent person. It was also the first documented report of staphylococcal septic arthritis directly related to a nonvenomous spider bite. In this publication, we present our diagnostic and treatment approach, compare it with other similar cases from the available literature, and discuss spider bites as a common and often downplayed complaint in patients returning from tropical areas in daily medical practice.