Sounds very possible it MAY be a brown recluse bite, BUT...I hope the doctor cultured it for him. My family has just finished going through a long ordeal with repetative stah aureus infections that look JUST LIKE brown recluse bites. In fact many of our sores were wrongly diagnosed as recluse bites, when they were actually staph skin sores. They also started out red with white centers that turned black a few days later, and made the surrounding area puff up and become quite sore and swollen. Both bites and staph are often given antibiotics, though the antibiotic may be different depending on whether staph or a bite. If cultured, they can have labs come back telling the doctor what type of staph is there and which antibiotics will work best for that type. What finally alleviated our sores once and for all (after each person had had five or six in a row!) was two rounds of antibiotics back to back, -- " Omnicef " to be exact. The other antibiotics (Cephlex, Suprax, Septra, etc.) helped each sore heal, but did not prevent more sores from springing up later. These staph sores ARE nice to know about, because they are VERY contagious; one can get more sores themselves, or pass them on to others by having the puss spread. In other words, if your friend touches his puss to his hand while cleaning his wound, then to a doorknob that someone else touches soon after or to another person's hand or arm, a sore can form on them, if it is not a spider bite but a staph infection. One infectious disease doctor we saw said he's seen a lot of skin staph aureus this year, for some reason. Not a good thing to have to deal with. I shouldn't think the doctor will have to cut the bite or infection area. My son's leg was swollen up 6 inches in circumference around the bite, because it didn't respond to the cream the doctor gave him to use (Bactriban). But they just gave him an antibiotic and it got lots better after two to three days. Good luck. I HOPE they thought to culture it for him! If not, he may want to go back while it is still providing puss and ask them to take some of the puss on a Q-tip and culture it.