Fatal spider envenomation: a systematic review of autopsy findings Abstract Background Fatal spider envenomation is exceptionally rare in contemporary medical practice; however, sporadic reports continue to appear in the forensic literature, often characterized by diagnostic uncertainty and heterogeneous documentation. This systematic review critically evaluated all published fatal cases attributed to spider envenomation, with emphasis on autopsy findings, histopathological patterns, and medico-legal robustness of causal attribution. Results A systematic search of PubMed/MEDLINE, Embase, and Scopus was conducted from database inception to 14 February 2026 in accordance with PRISMA 2020 guidelines. Twelve studies met predefined inclusion criteria and were included in the qualitative synthesis. Seven cases (58%) were supported by autopsy findings, while five were clinically well-documented fatalities without post-mortem examination. Loxosceles accounted for most cases (8/12), follo...
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