Spider Bites

[randreed]

This is the season when spiders look for warm places to hide and sometimes that means in your shed, garage, house, attic, crawlspace, basment, etc. Most household spiders do not have enough venom to cause much harm, but there is another prblem you need to watch out for if you are bitten - infection.

If you are bitten by a spider, please have it looked at by a medical professional right away (especially if it's not completely healed after a week). The resulting infection will be much more painful and very inconvenient from multiple trips back and forth to the doctor or hospital and days off from work - not to mention the cost of all those visits. Go early and get it taken care of right away!

Around Northern New Jersey you need to be careful of trhe little brown spiders that make flat webs with a little tube that they hide in at one end. These are called Brown Recluse spiders and they can be quite agressive when they are disturbed by cleaning, etc.

They like to hide in small dark spaces, so when you are cleaning, your pant-leg or shirt sleeve looks like a safe place to them. Once they are in your clothes, they will quickly bite because they feel threatened (while you are trying to get them out).

Anyway, just be careful out there . . . . .

[pete bogumill]

<div class='quotetop'>QUOTE(Rand Reed @ Oct 23 2006, 06:48 PM) [snapback]337086[/snapback]</div>

This is the season when spiders look for warm places to hide and sometimes that means in your shed, garage, house, attic, crawlspace, basment, etc. Most household spiders do not have enough venom to cause much harm, but there is another prblem you need to watch out for if you are bitten - infection.

If you are bitten by a spider, please have it looked at by a medical professional right away (especially if it's not completely healed after a week). The resulting infection will be much more painful and very inconvenient from multiple trips back and forth to the doctor or hospital and days off from work - not to mention the cost of all those visits. Go early and get it taken care of right away!

Around Northern New Jersey you need to be careful of trhe little brown spiders that make flat webs with a little tube that they hide in at one end. These are called Brown Recluse spiders and they can be quite agressive when they are disturbed by cleaning, etc.

They like to hide in small dark spaces, so when you are cleaning, your pant-leg or shirt sleeve looks like a safe place to them. Once they are in your clothes, they will quickly bite because they feel threatened (while you are trying to get them out).

Anyway, just be careful out there . . . . .
[/b]

thank you very much for the advice. it was nice that you told folks about this.. thank you pete

[efusco]

Ok, folks, time for me to stump speach a little.

First of all, I'm an ER physician.
Next, we see on the order of 5 to 10 people per day in my ED that present with a chief complaint of "possible spider bite". Out of these probably one per month is actually a spider bite. Out of those probably one every 6 months is a brown recluse.

Here's the approach I recommend.
If you notice a sore on your body that is red, hot, tender and looks like a spider bite, it is probably not a spider bite unless you saw the actual spider that bit you and/or felt the bite occur. More than likely what you have is something called CA-MRSA (Community Acquired Methacillin Resistant Staph Aureus) infection. This, moreso than a spider bite actually, needs immediate medical attention. They sometimes require I&D (incision and drainage--cut open to let the pus out) and, in all cases, require antibiotics... And NO, don't use that leftover amoxicillin that's been in the cabinet since you had strep throat 3 years ago...it won't work and will actually promote further resistance of the MRSA. You'll need Bactrim or Clindamycin...don't let the doctor put you on Keflex or anything else, tell him you're worried about MRSA. Nice article HERE


If you're certain it's a spider bite and you have the spider and it's identifiable then you have some options....
Brown Recluse and Black Widows are the only poisonous spiders that cause morbidity in the US. Black Widows have an antivenom, though it's rarely needed. However medical attention is often needed for pain control and muscle spasms. If it's a black widow you can either wait to see if you have symptoms then see a doctor, or start for the doctor immediately and if you don't have symptoms by the time you get there you probably won't develop any. If you do then you can get treatment right away. If you have a history of cardiac disease or other vascular disease and you are having chest pain or severe abdominal pain then you need to call 911 and go to the hospital immediately...those are indications for possible treatment with anti-venom.


If it's a brown recluse you can decide, on your own, what to do. Most of us will look at your bite, give you a random antibiotic, maybe even something fancy like Dapsone...all the while we know it won't do a bit of good. Some major hospitals that have hyperbaric chambers and an aggressive hyperbarics physician will sometimes dive fresh bites as there's some sketchy evidence that it could help. If you hate doctors and/or don't wanna pay the bill to see a doctor then it's perfectly acceptible to watch and wait. Brown recluse bites sometimes get very large and serious and require debridement--cutting away of the damaged tissue. This isn't from infection, it's from the toxin and we don't have an antidote for the toxin. If it's only a moderate size wound then watchful waiting is usually what we prescribe. These always look terrible and, inevitably, someone will put you on antibiotics, "just in case", but they rarely are actually necessary. However, it's reasonable to see a physician fairly early if it becomes clear that the wound will become fairly large and has potential for infection or to need surgical treatment...that way you can be refered and treated appropriately instead of just showing up once the would has gotten severe.


Hope that's not overly wordy.

[huskers]

Several years ago we had a small girl in our community that died from a brown recluse. Also, someone got bit in the foot at a Burger King and almost lost her foot.

[daniel]

Great! Something else to be worried about.

[koa]

Also watch out for areas where millions of gallons of raw sewage was dumped.

http://starbulletin.com/2006/04/05/news/story02.html

[efusco]

<div class='quotetop'>QUOTE(huskers @ Oct 23 2006, 09:22 PM) [snapback]337142[/snapback]</div>

Several years ago we had a small girl in our community that died from a brown recluse. Also, someone got bit in the foot at a Burger King and almost lost her foot. [/b]

Death and loss of limb are very very rare. Soft tissue loss is the main problem...it can be very extensive in some cases.

[naterprius]

e, why is there no antivenom for the brown recluse?

Nate

[AuntBee]

Loxoscelism, isnt' that the medical term for it?

[efusco]

<div class='quotetop'>QUOTE(naterprius @ Oct 23 2006, 11:13 PM) [snapback]337186[/snapback]</div>

e, why is there no antivenom for the brown recluse?

Nate [/b]

Don't know for sure, it's one of those things that since it's not really something that's life or limb threatening the cost of producing it, then rarely having it used wouldn't justify the manufacturer's efforts. I seem to recall that a anti-venom has been produced in small quantities by scientists.

Even Black Widow anti-venom is very hard to get and VERY expensive. The last case I had when I used it I had to sign papers I'd never seen before. The pharmacist had to have it couriered from the other local hospital b/c we didn't have it, the she brought it to me directly, wouldn't let the nurse sign for it, only me!