Brown Recluse Spider Bite

GENERAL INFORMATION:

What is a brown recluse spider bite?

• A brown recluse spider bite is a small wound that you get from being bitten by a brown recluse spider. Brown recluse spiders, also called fiddle back spiders, may have a violin-shaped mark on the top of their body. They are colored yellow-brown to gray-brown. Unlike other spiders with eight eyes in two rows, the brown recluse has six eyes arranged in three pairs. They are about the size of a United States (U.S.) quarter, have long legs, and are furry with fine hair on both body and legs. They are found in central and southern states in the U.S, living both indoors and outdoors. They prefer to live in dark, warm, dry places, are active at night and hide during the day. They are commonly found under rocks, boards, and woodpiles, in dark corners, and under furniture.
  
  
• Most bites happen between April and October as the brown recluse spider is inactive (hibernates) during winter. These spiders are shy and not aggressive, biting people only when threatened or pressed up against an object. They may hide in your shoes and clothing, or find their way into your bedding at night while you sleep. Their bites have venom (poison) that may enter your tissues and may cause wounds and illness. Most bites from these spiders are not harmful. For a small number of people, the wound may become severe (very bad) and can cause damage and loss of tissues.

What are the signs or symptoms of a brown recluse spider bite?

• Brown recluse spider bites on the hands or feet are common, but you may find them anywhere on your body. You may not feel anything at first. Within hours after the bite, you may have any of the following:
  
  
  • Mild burning feeling or irritation on the bite wound.
    
    
  • Pain, redness, itching, and swelling on the bitten area of your skin.
  
  
• The venom may cause severe skin and tissue damage after several hours or days. You may see any of the following:
  
  
  • Severe swelling and pain at the site.
    
    
  • Blister (fluid-filled elevation on your skin) that is blue in the center and ringed by redness.
    
    
  • Pimple-like lesion with pus (yellow or greenish discharge).
    
    
  • Ulceration (break in skin or mucous membrane with loss of surface tissue).
    
    
  • Death of tissue in the wound site.
  
  
• The venom may also act as a poison in your body. You may have any of the following:
  
  
  • Dark colored urine.
    
    
  • Fever, chills, nausea and vomiting, or convulsions (seizures).
    
    
  • Joint pains.
    
    
  • Rashes.

How is a brown recluse spider bite diagnosed? Certain medical conditions, such as diabetes or unhealed sores, may have the same skin changes as that of a spider bite. A clear diagnosis of brown recluse spider bite is made if the spider can be collected or captured and properly identified. If you believe you may have been bitten by a spider, you should attempt to find it to show to your caregiver. Your caregiver may ask you questions about your medical history. He may also do a physical exam on you. You may need to have the following:

• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Skin biopsy: A sample of your skin tissue is removed and sent to a lab for tests. Caregivers put numbing medicine into your skin so you will have little pain. A bandage is put on the biopsy area after the tissue sample is taken.
  
  
• Urine test: A sample of your urine is collected and sent to a lab for tests.

How is a brown recluse spider bite treated? Put ice on the site of the spider bite, elevate the wound area, and keep it above the level of your heart. This is to help decrease redness and swelling. You may also put a compression bandage to the wound site. A brown recluse spider bite may heal on its own without treatment. It is important to clean the wound site with soap and water. If the bite wound gets worse or you get sick, you may need any of the following:

• Medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Antihistamines: This medicine may be given to help decrease itching.
    
    
  • Anti-venom: Anti-venom may be given to help fight the poison that you received. Ask your caregiver for more information on anti-venom medicine.
    
    
  • Steroids: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling.
    
    
  • Tetanus shot: This is medicine to keep you from getting tetanus. It is given as a shot. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.
  
  
• Other treatments:
  
  
  • Surgery: This is done if the damaged tissue around your wound becomes large and needs to be removed. Cleaning and removing dead tissues may help the wound to heal faster. Ask your caregiver for more information about selective methods of debridement (removing dead tissue).
    
    
  • Hyperbaric oxygen therapy: This is also called HBO. HBO is used to get more oxygen into your body. The oxygen is given under pressure to help it get into your tissues and blood. You may be put into a tube-like chamber called a hyperbaric or pressure chamber. You will be able to see your caregivers and talk with them through a speaker. You may need to have this therapy more than once.

How can a brown recluse spider bite be prevented? Find out if you live in an area where there are brown recluse spiders. Learn what these spiders look like and where they like to hide. Teach your family to avoid these spiders. A brown recluse spider bite may be prevented by doing the following:

• Cleaning closets, sheds, and attics completely. Remove woodpiles and other trash from outside areas, especially piles of things where spiders can live. Wear gloves, long sleeved shirts, pants, and shoes when you do work near wood or garbage piles.
  
  
• Making noises when entering attics or other spaces where spiders may live. Noise may scare them away.
  
  
• Shaking out clothes or shoes that are lying on the floor before putting them on. Check under your bed sheets before getting in bed. Clothing that has been stored should be aired out and carefully searched for spiders before it is worn.
  
  
• Using caution in removing a web or spider when you see one.
  
  
• Being attentive to your surroundings when traveling in areas where these spiders are common.

When should I call my caregiver?

• You have a skin rash, itching, or swelling after taking your medicine.
  
  
• You have increased redness, numbness, or swelling in the bitten area.
  
  
• You have pain or problems moving the injured part or get tender lumps in the groin or armpits.
  
  
• You have questions or concerns about your injury, medicine, or care.

When should I seek immediate help?

• You have a fever or chills.
  
  
• You have a headache, or nausea (upset stomach) and vomiting (throwing up).
  
  
• You have numbness or tingling in the area of the bite.
  
  
• You have trouble talking, walking, or breathing.
  
  
• You start passing dark urine or less urine than is usual for you.
  
  
• Your wound does not stop bleeding even after applying pressure.
  
  
• Your wound or bandage has pus or a bad smell even if you are cleaning it everyday.

Where can I find more information? Contact any of the following:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• Centers for Disease Control and Prevention
  1600 Clifton Road
  Atlanta, GA 30333
  Phone: 1-404-6393311
  Phone: 1-800-3113435
  Web Address: http://www.cdc.gov
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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