When both types of loxoscelism do result, systemic effects may occur before necrosis, as the venom spreads throughout the body in minutes. Children, the elderly, and the debilitatingly ill may be more susceptible to systemic loxoscelism. The systemic symptoms most commonly experienced include nausea, vomiting, fever, rashes, and muscle and joint pain. Rarely, such bites can result in hemolysis, thrombocytopenia, disseminated intravascular coagulation, organ damage, and even death. Most fatalities are in children under the age of seven or those with a weak immune system.