Abstract
A 37-year-old man presents with localized swelling and tenderness of the left leg just below the knee; he suspects a spider bite. Examination shows a 5-by-7-cm area of erythema and warmth. A small area of necrotic skin covers a central, fluctuant 2-by-2-cm area. The temperature is 38.3°C, the pulse rate 115 beats per minute, and the blood pressure 116/78 mm Hg.

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