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July 3, 2002

Diagnosis and Treatment of Cutaneous Anthrax—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(1):43-44. doi:10.1001/jama.288.1.42

In Reply: We agree with Dr Suchard that necrotic arachnidism in an infant in Manhattan is unlikely. However, we could not rule out this possibility. Although Loxesceles spiders are most concentrated in the south central United States, Loxesceles species have been sporadically identified in virtually every state in the continental United States, probably transported in belongings.1,2 In this case, the family's automobile had recently been driven to regions inhabited by Loxosceles species and we postulated that a spider might have hidden within the infant's stroller or the family's belongings.