Brown recluse spider bites: a complex problem wound. A brief review and case study.
Brown recluse spiders (Loxosceles reclusa) are responsible for virtually all documented cases of spider bites leading to significant necrosis. The actual spider bite often goes unnoticed for as long as 4 to 6 hours, which makes diagnosis and, therefore, appropriate treatment, difficult. The spider bite generally results in either a necrotic wound or systemic symptoms that can lead to hemolysis. The patient described in this article experienced both complications. Dapsone and hyperbaric oxygen therapy brought the adverse response to the bite under control. The patient was hospitalized for 7 days during treatment for hemolysis and an extensive, necrotic wound. Efforts are underway to develop an assay to provide a definitive diagnosis for the brown recluse spider bite, but none is yet commercially available. Antivenom is scarce; capture of the offending spider appears to be most helpful in the diagnosis and proper treatment of spider bites.
Department of Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA. jrwilson@uta.edu
Judy R
JR
Wilson
Clyde O
CO
Hagood
Irvine D
ID
Prather
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000997:Antivenins / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003622:Dapsone / Q000627:therapeutic use; D003646:Debridement; D003937:Diagnosis, Differential; D004155:Diphenhydramine / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006386:Hemagglutination Tests; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation; D015994:Incidence; D009336:Necrosis; D012621:Seasons; D017592:Skin Care / Q000379:methods; D016038:Skin Transplantation; D001098:Spider Bites / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D013111:Spider Venoms / Q000009:adverse effects / Q000737:chemistry; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014945:Wound Healing
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000997:Antivenins; D006634:Histamine H1 Antagonists; D013111:Spider Venoms; D004155:Diphenhydramine; D003622:Dapsone