Brown recluse spiders are indigenous to the southeastern, south central and southwestern United States. They live in dark, undisturbed places like basements, boxes, and closets and are most active at night. Venom from the brown recluse is destructive to the red blood cells in the human body.
Identification of Brown Recluse
The brown recluse spider is also known as the fiddleback or violin back spider. The spider is light brown in color with a dark brown fiddle-shape mark that extends from the six white eyes down the back of the spider. Both the male and female spider can envenomate.
Symptoms
According to "Sheehy's Emergency Nursing Priniciples and Practice," the bite from the brown recluse is typically painless and findings of the bite may not be noticed for 6 to 12 hours. The bite causes the development of a piece of black dead skin, called eschar. The envenomation spreads to tissue around the bite and causes premature death of the tissues. When this happens, the the area where the cells have died slough off. It may be 48 to 72 hours after the bite before the progression of cell death is visible. As the wound progresses, it becomes painful.
Immediate Treatment
Treatments for the bite of the brown recluse have been varied. According to the University of Maryland Medical Center, the best course of action is to wash the area with soap and water, apply ice and seek medical attention. In most cases, the wound heals without complications within two to three months.
Considerations
Antibiotics may be added as part of the treatment if skin tissue breaks down, creating an entry site for bacteria. According to "Sheehy's Emergency Nursing Principles and Practice," for most patients no systemic agent can be recommended to prevent the death of the tissues, and there was no commercial antivenin available for the brown recluse as of the 2010 publication date. One medication, Dapsone, has been shown to limit tissue destruction in some experimental models, but the results have been mixed and abnormal blood conditions are associated with the use of this medication.
Surgical Intervention
In wounds where there is significant death of the tissue, it may be advised that the area be surgically removed. This is usually done only after six to eight weeks of wound care, allowing the tissue to die and the normal healing process to begin. In some instances, skin grafting may be required to completely repair the damage.
References
- "Sheehy's Emergency Nursing Principles and Practice"; Mosby Elsevier; 2010
- "Sheehy's Manual of Emergency Care"; Mosby Elsevier; 2005
- University of Maryland Medical Center: Brown recluse spider - treatment
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