Vanderbilt University researchers are reporting an increase in cases of brown recluse spider bites.
These bites can lead to systemic symptoms in rare cases; the syndrome, known as systemic loxsoscelism, can lead to symptoms such as a fever, rash, and muscle pain. If a breaking of the red blood cell membrane occurs it can result in fatality, especially if it occurs in children.
"Our recommendations are 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, which indicates hemolysis," said Tennessee Poison Center Medical Director Donna Seger, M.D. "If the urine is positive for blood and/or the child has other signs of systemic loxsoscelism, the child should be admitted and observed for hemolysis. If the urine dip is negative, and there are no other signs of systemic loxsoscelism, the child should be seen by a physician the next day."
The brown recluse spider is usually light to medium brown but can range from cream-colored to blackish-gray. It has six eyes rather than the typical eight and can be most conclusively identified by the violin-shaped marking on its back. Researchers are not sure why systemic symptoms occur in some individuals and not others. In many cases it is better if the lesion is left alone to heal, and in many instances it is over-handled.
"As physicians, it is hard for us to do nothing. 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. Ointments, antibiotics and dapsone are not recommended. Ice works better than opiates for pain," Seger said.
