Severe intravascular haemolysis due to brown recluse spider bite: A life threatening but treatable condition

A 44-year-old male gardener presented with fever, vomiting and necrotic sloughing skin following a sting by an insect while removing dead leaves from palm trees. On day 3 of his hospital stay he developed jaundice and severe Coomb's-positive haemolytic anaemia. He continued to deteriorate despite intensive treatment with intravenous fluids replacement, blood transfusion and antibiotics. He eventually made an excellent recovery with high dose intravenous steroids.