title: Surgical treatment of a brown recluse spider bite: a case study and literature review.
abstract: Spider bite envenomation can cause local, constitutional, and/or systemic symptoms. The present case study reports on 5 years of follow-up for a "probable" brown recluse spider bite of the foot and ankle that was refractory to conservative treatment and was subsequently treated with surgery. The present case study reports the atypical occurrence of long-term peripheral neuropathy after necrotic arachnidism induced by "probable" brown recluse (Loxosceles recluse) envenomation, in a 46-year-old male. The state of published data suggests to minimize inflammation and tissue necrosis, prevent bacterial superinfection, and control pain levels. For patients with long-term peripheral neuropathy refractory to conservative therapy, surgical intervention may further improve their symptoms.
authors.affiliation: Resident, Department of Radiology, Mount Sinai Medical Center, Miami Beach, FL. Electronic address: LawrenceDelasotta@Gmail.com.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Delasotta
authors.affiliation: Assistant Professor, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Fabio
authors.initials: F
authors.lastname: Orozco
authors.affiliation: Assistant Professor, Thomas Jefferson University Hospital, Philadelphia, PA; Director, Orthopaedics Division, AtlantiCare Regional Medical Center, Pomona, NJ; and Assistant Professor, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Alvin
authors.initials: A
authors.lastname: Ong
authors.affiliation: Nerve and Hand Surgeon, Institute for Nerve, Hand, and Reconstructive Surgery, Rutherford, NJ.
authors.forename: Emran
authors.initials: E
authors.lastname: Sheikh
mesh_terms: D063287:Brown Recluse Spider; D059350:Chronic Pain / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000601:surgery*; D001098:Spider Bites / Q000150:complications / Q000601:surgery*
keywords: 4; Loxosceles; deep peroneal nerve; necrotic arachnidism; peripheral neuropathy; surgery