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Brown recluse spider bites often treated improperly
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Toxicologists at Vanderbilt University Medical Center have reported an increase in patients with brown recluse spider bites this summer, according to a press release.
The bites often heal well if left alone; however patients tend to apply treatments before seeking medical advice and physicians sometimes unnecessarily cut out the lesion, Donna Seger, MD, medical director of the Tennessee Poison Center and a professor of clinical medicine at Vanderbilt University Medical Center, said in the release.
The spider is recognized by the violin-shaped marking on its back. Its bite is composed of two components, a cutaneous lesion and rare, systemic symptoms occurring after the bite. Systemic loxsoscelism occurs when the bite is “accompanied by fever, rash and muscle pain, with or without hemolysis,” the release said.
“We don’t know why systemic loxsoscelism occurs in some people with brown recluse spider bites and not in others, but it is life-threatening and does require immediate medical attention,” Seger said. “Toxin-induced hemolysis can occur very rapidly and therein lies the threat, especially in children.
“Our recommendation is that all children under 12 years of age with a brown recluse spider bite should have a urine test for the presence of hemoglobin in blood.”
The child should be admitted to the hospital and observed for hemolysis “if the urine is positive for blood and /or the child has other signs of systemic loxsoscelism,” Seger said. A follow-up should be scheduled the next day if the urine dip is negative, and there are no other signs of systemic loxsoscelism.
There is no need for a urine test in adults who are bitten but do not experience rash, fever or muscle pain.
“As physicians, it is hard for us to do nothing,” Seger said. “The cutaneous lesion has classic characteristics, but if physicians are not familiar with this bite, the tendency is to debride and cut out the lesion. This actually slows the healing process and can result in disfigurement that would not occur if the lesion were left alone.”