Edit concept Question Editor Create issue ticket

Brown Recluse Spider Bite


Presentation

  • A review of the literature on brown recluse spider bite is presented, including clinical presentation and treatment. Emphasis is placed on the treatment of local tissue necrosis.[ncbi.nlm.nih.gov]
  • Clinical presentation and course of a known brown recluse spider bite. Complete recovery with cicatrization at the site of the bite.[ncbi.nlm.nih.gov]
  • STUDY OBJECTIVE: To examine the clinical presentation and outcome of patients treated in the ED or toxicology clinic for suspected brown recluse spider bites.[ncbi.nlm.nih.gov]
  • 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.[ncbi.nlm.nih.gov]
  • The article presents process for diagnosis and stresses the importance of identifying the spider if at all possible.[ncbi.nlm.nih.gov]
Fever
  • Brown recluse spider bites can lead to severe local or systemic clinical effects, such as edema, necrotic ulcer, rashes, fever, chills, nausea, vomiting, malaise, arthralgia, myalgia, hemolysis, leukocytosis, disseminated intravascular coagulation, renal[ncbi.nlm.nih.gov]
  • If fever and nausea develop, treatment may be required to alleviate these symptoms. Home Care and Prevention The initial home care is to clean the skin wound with hydrogen peroxide, chlorhexidine or povidone iodine.[petplace.com]
  • Also, unlike other spiders that have 4 pairs of eyes, the brown recluse has 3 pairs, which is a distinguishing factor Brown Recluse Spider Bites can result in itching, fever, chills, and fatigue.[dovemed.com]
  • "I was having a fever all the time, very nauseous, very lethargic, tired all the time," she explained. Doctors believe she may have been bitten by the rare brown recluse spider--so they treated her with strong antibiotics and a round of steroids.[abc12.com]
  • "If the urine is positive for blood and/or the child has other signs of systemic loxsoscelism (rash, fever), the child should be admitted and observed for hemolysis.[techtimes.com]
Chills
  • Brown recluse spider bites can lead to severe local or systemic clinical effects, such as edema, necrotic ulcer, rashes, fever, chills, nausea, vomiting, malaise, arthralgia, myalgia, hemolysis, leukocytosis, disseminated intravascular coagulation, renal[ncbi.nlm.nih.gov]
  • Also, unlike other spiders that have 4 pairs of eyes, the brown recluse has 3 pairs, which is a distinguishing factor Brown Recluse Spider Bites can result in itching, fever, chills, and fatigue.[dovemed.com]
  • The most common symptoms were pain, pruritus, malaise, chills, sweats, and rash. Patients were randomized into three treatment groups: dapsone, brown recluse spider antivenom, or combination therapy. All patients were treated with erythromycin.[ncbi.nlm.nih.gov]
  • Signs and symptoms of Brown Recluse Bites Include: Fever and chills: If the bite is extremely severe, the patient may experience chills and even shock, but these cases are very rare.[associatedderm.net]
Malaise
  • Brown recluse spider bites can lead to severe local or systemic clinical effects, such as edema, necrotic ulcer, rashes, fever, chills, nausea, vomiting, malaise, arthralgia, myalgia, hemolysis, leukocytosis, disseminated intravascular coagulation, renal[ncbi.nlm.nih.gov]
  • The most common symptoms were pain, pruritus, malaise, chills, sweats, and rash. Patients were randomized into three treatment groups: dapsone, brown recluse spider antivenom, or combination therapy. All patients were treated with erythromycin.[ncbi.nlm.nih.gov]
  • Other symptoms can include a general feeling of discomfort (malaise), fever, nausea, and vomiting. In most cases, the bite site heals on its own within a week. But in some cases, the skin at the bite site may break down.[mountnittany.org]
  • Systemic manifestations may include fever, chills, nausea and vomiting, diarrhea, myalgias, arthralgias, malaise, rash, and headache. History of present illness Symptoms (if noted) typically develop two to six hours after bite.[clinicaladvisor.com]
  • Brown Recluse Spider bites may produce a range of symptoms known as ‘loxoscelism’ (a condition produced by the bite and characterized by a gangrenous slough at the site of bite, nausea, malaise, fever, hemolysis and thrombocytopenia).[animalcorner.co.uk]
Localized Pain
  • Symptoms and Types May be no symptoms Local pain and stinging (may last 6–8 hours), followed by itching and soreness Lesion - white with a dark central scab on an uneven red background; after 2–5 weeks a central scab may slough, leaving a deep, slow healing[petmd.com]
  • Practice recommendations Be concerned about brown recluse envenomation when a patient reports intensifying localized pain disproportionate to physical findings after a “bite” ( C ).[mdedge.com]
  • A more intense, local pain, often with pruritus occurs after 6-8 hours. As the lesion progresses, the erythema with central mottling may develop a bleb or blister.[medicine.mc.vanderbilt.edu]
  • Bite from a spider Symptoms of a Spider Bite Most spider bites cause local pain, redness and swelling. It's much like a bee sting reaction. A few spiders (such as the Black Widow) can cause a more severe reaction.[seattlechildrens.org]
Asymptomatic
  • Most spider bites are asymptomatic but what makes this bite so devastating is the toxin injected by the brown recluse spider, which can cause considerable systemic symptoms as well as necrotic skin ulcers (necrotic arachnidism).[ncbi.nlm.nih.gov]
  • In later follow-up office visits, the patient has been asymptomatic, with maintained strength and mobility.[elsevier.es]
  • Initially asymptomatic, the bites may evolve into very painful, slowly resolving scarring lesions.[jamanetwork.com]
Nausea
  • Brown recluse spider bites can lead to severe local or systemic clinical effects, such as edema, necrotic ulcer, rashes, fever, chills, nausea, vomiting, malaise, arthralgia, myalgia, hemolysis, leukocytosis, disseminated intravascular coagulation, renal[ncbi.nlm.nih.gov]
  • If lethargy, vomiting or nausea occur, there is no home care and seeking veterinary assistance is strongly recommended. The primary prevention is to limit your dog’s access to brown recluse spiders.[petplace.com]
  • Nausea or vomiting: Besides affecting the rest of the body, some symptoms of a brown recluse spider include nausea. You may feel mildly ill with nausea and feverish until your body can process the spider venom.[associatedderm.net]
  • Medicines may cause nausea or vomiting. You may have sore throat, or your skin may become pale or yellowish. You may develop soreness, redness, or swelling in the muscle where the tetanus shot was given.[drugs.com]
Vomiting
  • Brown recluse spider bites can lead to severe local or systemic clinical effects, such as edema, necrotic ulcer, rashes, fever, chills, nausea, vomiting, malaise, arthralgia, myalgia, hemolysis, leukocytosis, disseminated intravascular coagulation, renal[ncbi.nlm.nih.gov]
  • Medicines may cause nausea or vomiting. You may have sore throat, or your skin may become pale or yellowish. You may develop soreness, redness, or swelling in the muscle where the tetanus shot was given.[drugs.com]
  • Symptoms of a Brown Recluse Bite Nausea Vomiting Fever Rashes Muscle and joint pain Over the next few days necrosis (the skin and other tissue dies) at the site of the bite may develop.[firstaidanywhere.com]
  • An ulcer or blister that turns black Headache and body aches Rash Fever Nausea or vomiting The symptoms of a brown recluse spider bite may look like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.[hopkinsmedicine.org]
  • He also wrote that he went to the ER about six hours after the bite because he was vomiting and experiencing chills. Eventually, a doctor suspected that it was likely a brown recluse bite based on the symptoms, KilledTheCar wrote.[businessinsider.com]
Cyanosis
  • The bite site may develop a blue macule or a characteristic erythematous lesion with surrounding pallor encircled by an area of cyanosis. Over the next week an eschar may develop and slough.[cancertherapyadvisor.com]
Leg Pain
  • Case Report A 58-year-old female presented to our emergency department (ED) with sudden leg pain and rash starting 12 h ago [Figure 1] a. The rash at this time was most consistent with cellulitis and treated with cephalexin.[ijam-web.org]
Quickening
  • She also attributes her quickened recovery to a recent 30-pound weight loss, explaining, “I was very healthy when I was bit.” Still, Linsey was concerned about the obvious gash on her face as she prepared to get back on the road to tour.[people.com]
Blister
  • "The blistering and infection got worse," Greenwald said. "I was having flu-like symptoms such as nausea, fever, loss of appetite."[cbsnews.com]
  • What began with slight blistering quickly developed into this - a huge fluid filled blister on her arm.[abc12.com]
  • The next morning, the red spot began to blister and hurt even more. Greenwald did not hesitate anymore and went to her family doctor. Doctors determined that Greenwald suffered a spider bite.[mlive.com]
  • The first is stinging and redness followed by pain radiating from the bite wound and then a blister and ulcer.[livestrong.com]
  • A small white blister can also form at the site.[healthline.com]
Pruritus
  • The most common symptoms were pain, pruritus, malaise, chills, sweats, and rash. Patients were randomized into three treatment groups: dapsone, brown recluse spider antivenom, or combination therapy. All patients were treated with erythromycin.[ncbi.nlm.nih.gov]
  • FACT: Typically, bites cause pain, erythema, and sometimes pruritus; tissue necrosis involving underlying tissue or muscle, a serious complication, is fortunately rare. A bulla resembling a bull's eye may form at the site. Deborah H.[journals.lww.com]
  • Symptoms range from asymptomatic patients, local signs around the bite area, to systemic repercussion with kidney failure. 1,2 Pain presents within the first few hours and progressively increases in intensity, with associated pruritus and erythema. 24[elsevier.es]
  • Chief concern Sensation at site of bite may range from pruritus to severe, burning pain. Systemic manifestations may include fever, chills, nausea and vomiting, diarrhea, myalgias, arthralgias, malaise, rash, and headache.[clinicaladvisor.com]
  • A more intense, local pain, often with pruritus occurs after 6-8 hours. As the lesion progresses, the erythema with central mottling may develop a bleb or blister.[medicine.mc.vanderbilt.edu]
Skin Ulcer
  • Most spider bites are asymptomatic but what makes this bite so devastating is the toxin injected by the brown recluse spider, which can cause considerable systemic symptoms as well as necrotic skin ulcers (necrotic arachnidism).[ncbi.nlm.nih.gov]
  • —Commonly misidentified; expert identification preferred Rule out Bites/stings from other arthropods/arachnids (at least 60 species of spiders have been implicated in human bites) Vascular occlusive disease, venous stasis, diabetic skin ulcers, vasculitis[clinicaladvisor.com]
  • According to the CDC, necrosis -- death of the tissue -- is caused by the brown recluse spider's venom, and necrosis can make the skin ulcerate, slough off or turn black after 3 to 4 days.[livestrong.com]
  • Skin ulceration results from a combination of localized endothelial cell damage by venom and ischemia secondary to inflammation caused by leukocyte infiltration. Hemolysis and intravascular coagulation may occur in cases of systemic toxicity.[calpoison.org]
Flushing
  • I flushed the toilet with a feeling of personal victory. Almost within the hour the bite area swelled to a quarter size area. That afternoon I went to the doctor and he asked me if it was a brown recluse.[budgetpestcontrol.com]
  • An IV should be started along with fluids by mouth to flush the kidneys in case of hemolysis.[o-wm.com]
  • Several traps should be placed into corners and flush along walls. The more glue traps used the better — dozens placed throughout a home will reveal areas where spiders are most abundant.[entomology.ca.uky.edu]
  • It is preferred to perform the first change of medium under sterile conditions five days after the placement of the cell culture is as follows: The medium bottle is held so that as much of the medium contained therein is poured out, flush with without[google.nl]
Skin Plaque
  • We report a case of a brown recluse spider bite that presented as a chronic painful skin plaque, with the unusual histologic findings of a cutaneous and deep subcutaneous hyalinizing panniculitis and myonecrosis.[ncbi.nlm.nih.gov]
Facial Edema
  • We report a child with severe facial edema and a dermonecrotic ulcer on the eyelid. Upon laboratory examination, leukocytosis with a significant left shift was detected.[ncbi.nlm.nih.gov]
Kidney Failure
  • In case of systemic toxicity, they have been used to prevent kidney failure 8 and haemolysis.[elsevier.es]
  • These can include muscle damage, kidney failure, problems with blood clotting, and coma. The bite site is cleaned. Medicines may be given to relieve pain, if needed. Antibiotics may also be given to treat infection. A tetanus shot may be given.[fairview.org]
  • These can include muscle damage, kidney failure, problems with blood clotting, and coma. The bite site will be cleaned. Medications may be given to relieve pain, if needed. Antibiotics may also be given to treat infection.[mountnittany.org]
  • And the brown recluse's venom can cause serious wounds or kidney failure, so isn't to be trifled with, either. The aptly named mnemonic NOT RECLUSE could help limit misdiagnoses and make sure people get the right treatment.[npr.org]
Hematuria
  • Elevated lactate dehydrogenase (LDH) is consistent with hemolysis. 7 Urinalysis may reveal hemoglobinuria, but not hematuria, as a result of hemolysis. 2 , 9 Urine may be dark and high levels of urobilinogen may be present, suggesting extravascular hemolysis[academic.oup.com]
  • In order to be considered a confirmed case of BRSB hemolysis, cases had to have clinical documentation of a recent insect bite, signs (hematuria, fever, or jaundice) or symptoms (abdominal pain) supportive of hemolysis, as well as a hematocrit of less[journals.plos.org]
  • There are also cases of hemolytic anemia and hematuria which are associated with sensory disorders. The body temperature can rise up to 41 degrees Celsius, with can also set a coma in severe cases.[google.nl]
Confusion
  • This can lead to tragedy because about 40 medical conditions, including several deadly bacterial infections, can be confused with brown recluse bites.[sciencedaily.com]
  • Early findings can be confusing. Brown recluse bites typically feel like a pin prick. A vasoconstrictive halo may surround the bite, but this sign is inconsistent.[mdedge.com]
  • Here’s to hoping you don’t get bit by a spider, or worse, get anthrax that your doctor confuses for a spider bite. [ JAMA Dermatology ][gizmodo.com]
  • Most false sightings are due to confusion with one of the 13 other species found in the same family. The most common non-brown recluse spiders are the desert recluse found in Texas, Arizona, and California, and the Arizona recluse.[emedicinehealth.com]
Dysesthesia
  • Patients with brown recluse spider bites commonly suffer from pain, muscular aching, and a variety of local dysesthesias during the acute and resolution phases of toxin-induced injury.[ncbi.nlm.nih.gov]
Peripheral Neuropathy
  • For patients with long-term peripheral neuropathy refractory to conservative therapy, surgical intervention may further improve their symptoms.[ncbi.nlm.nih.gov]
Neglect
  • Permissions August 27, 1973 JAMA. 1973;225(9):1109-1111. doi:10.1001/jama.1973.03220370047013 Full Text Severe cutaneous necrosis is reported commonly as a consequence of Loxosceles spider bites; however, the description of mild cutaneous reactions has been neglected[jamanetwork.com]

Workup

  • Lab workup showed: 29 720 leukocytes/μl (85% polymorphonuclear); PCR 14.7; lactate 1.1; CPK 138; urea 32; creatinine 0.98; other parameters were normal. Chest radiograph was normal. Doppler ultrasound of the lower extremities was normal.[elsevier.es]
  • Patients with significant wounds and/or systemic symptoms require an extensive workup. The wound should be cleaned and dressed; an ice pack should be applied. 13,14 As with any insect bite, tetanus toxoid should be given, along with analgesics.[o-wm.com]
Borrelia Burgdorferi
  • Tick bite and infection with Borrelia burgdorferi should be considered in the differential diagnosis of necrotic arachnidism in regions endemic for Lyme disease.[ncbi.nlm.nih.gov]

Treatment

  • Even with early treatment, prognosis often is poor. Future studies might help establish better treatment regimens.[ncbi.nlm.nih.gov]
  • Abstract The objectives in the treatment of the brown recluse spider bite are to prevent skin necrosis and the need for reconstructive surgery.[ncbi.nlm.nih.gov]
  • Successful treatment of necrotizing fasciitis from any cause is associated with early diagnosis, immediate surgical debridement, and supplemental enteral or parenteral nutrition.[ncbi.nlm.nih.gov]
  • A positive PHAI test result could function as an entry criterion for BRS bite victims in human treatment trials.[ncbi.nlm.nih.gov]
  • Management of eyelid bites is difficult because the initial spider bite is frequently unnoticed, surgical and medical treatments are ineffective, and even a small area of necrosis affects the appearance and function of the eyelid.[ncbi.nlm.nih.gov]

Prognosis

  • Even with early treatment, prognosis often is poor. Future studies might help establish better treatment regimens.[ncbi.nlm.nih.gov]
  • What is the Prognosis of Brown Recluse Spider Bite? The prognosis is dependent on the location of bite, the severity of reaction, and the overall health of the individual.[dovemed.com]
  • […] to three days signals good prognosis) Fatty areas, such as proximal thigh and buttocks, may develop more cutaneous reaction/extensive necrosis.[clinicaladvisor.com]

Etiology

  • Making the diagnosis No specific diagnostic test is available, and the condition may be overdiagnosed (used as a catch-all diagnosis for necrotic skin lesions of uncertain etiology).[clinicaladvisor.com]
  • (Etiology) Brown Recluse Spider Bites release a small amount of poisonous venom into the skin.[dovemed.com]
  • Prevelance- The diagnosis of brown recluse spider bite is overused for dermonecrotic wounds of uncertain etiology. Check out this link discussing recluse spiders in Florida …state.fl.us/pi/enpp/ento/entcirc/ent406.pdf[tripadvisor.com]
  • Misdiagnosing dermonecrotic wounds of unclear etiology as spider bites is a worldwide issue, and has been reported in other countries such as Australia, New Zealand and Brazil. 4,5 Finally, the “deadly” reputation of these spiders has been largely predicated[calpoison.org]

Epidemiology

  • Since the diagnosis is difficult, clinical and epidemiological findings and a detailed history are important for an accurate diagnosis.[ncbi.nlm.nih.gov]
  • The purpose of this article was to provide a comprehensive epidemiological and clinical description of the brown recluse spider bite. Review of evidenced-based scientific literature and practice guidelines.[ncbi.nlm.nih.gov]
  • Epidemiology Loxosceles reclusa, the brown recluse spider, is endemic to the south-central United States, ranging from Texas to Georgia and from Louisiana to Iowa. 1 Isolated specimens have been found in association with recent shipments of goods into[calpoison.org]
  • Epidemiology Loxosceles reclusa , the brown recluse spider, is endemic to the south-central United States, ranging from Texas to Georgia and from Louisiana to Iowa. 1 Isolated specimens have been found in association with recent shipments of goods into[calpoison.org]
  • Epidemiology of the brown recluse spider bite . J Am Acad Nurse Pract . 2007 ; 19 : 79 – 85 . 3 . Brown recluse spider bites . Dermatol Nurs . 1999 ; 11 : 427 – 433 . 4 . Bites of brown recluse spiders and suspected necrotic arachnidism .[academic.oup.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiological studies in laboratory animals yield conflicting results and therapeutic recommendations because of technical and species-specific differences.[ncbi.nlm.nih.gov]
  • Pathophysiology True envenomation by the brown recluse spider is associated with development of necrotic skin wounds. Loxosceles reclusa venom contains several cytotoxic enzymes.[calpoison.org]
  • Pathophysiology Brown recluse spider bites can cause significant cutaneous injury with tissue loss and necrosis. Less frequently, more severe reactions develop, including systemic hemolysis, coagulopathy, renal failure, and, rarely, death.[emedicine.medscape.com]

Prevention

  • Abstract The objectives in the treatment of the brown recluse spider bite are to prevent skin necrosis and the need for reconstructive surgery.[ncbi.nlm.nih.gov]
  • The state of published data suggests to minimize inflammation and tissue necrosis, prevent bacterial superinfection, and control pain levels.[ncbi.nlm.nih.gov]
  • Medical News Today notes that preventative measures are pretty simple, and can go a long way in preventing brown recluse bites.[bustle.com]
  • Veterinary care is generally recommended to prevent additional tissue damage.[petplace.com]
  • Here, we aimed to clarify the clinical details of envenomation, to determine the efficacy of the complement inhibitor eculizumab to prevent the hemolysis in vitro, and to investigate markers of exposure to Brown Recluse venom.[ncbi.nlm.nih.gov]

Summary

Brown recluse spiders (loxosceles reclusa) are part of the loxosceles species of spiders in the United States of which there are 13 different species, 11 native and two nonnative. The brown recluse spider is the most common spider linked to brown spider bites. These bites were originally reported in the US in the 1800s and are still reported today. These bites are so prevalent and serious that the brown recluse spiders are thought to be a clinical concern [1].

Normally, these bites happen without any notice since they usually occur without any pain [2]. If an individual does feel something at the instance of a bite it is usually described as a similar feeling to a bee sting. When this spider bite happens, it causes skin and tissue injury in the affected area due to the venom of the spider. This localized or generalized symptoms following a bite are called loxocelism.

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!
Last updated: 2019-06-28 10:13