Spider bite requires visit to doctor

Q My daughter-in-law was bitten by a brown recluse spider near her ankle last month. The spot looks purple. What would you do? — JH, Anderson

A Your description of your daughter-in-law’s wound from a spider bite is very typical. If the wound is closed, then the purple discoloration will remain and no treatment is indicated. If the wound is an open lesion, she should consider a referral to a specialist.

Many spider bites happen without a person realizing that they have been bitten. Two spiders that are most likely to cause serious bites are the brown recluse and the black widow. The brown recluse spider is found in the southern and midwestern regions of the United States and has been found in the Upstate.

The brown recluse ranges in color from tan to dark brown and has a violin-shaped dark marking on the upper body. It is not aggressive, and most bites occur when people use some item that has been in undisturbed areas. Shoes and clothing not worn for a long time, unused bedding, or cleaning out storage areas in garages or sheds can bring someone in contact with the spider. The spider normally bites only when crushed, handled or disturbed.

The amount of venom injected with the bite and an individual’s sensitivity to the venom influence the severity of the bite. Some people are not aware of the bite at the time it occurs, but have a delayed reaction from two to eight hours later. Other people will have an immediate stinging sensation followed by intense pain.

A small white blister surrounded by a large congested and swollen area occurs at the site of the bite. Within 24 to 36 hours, a systemic (total body) reaction can occur with chills, fever, nausea, weakness, joint pain and restlessness present.

The spider’s venom contains an enzyme that destroys the cell membranes in the wound area. The affected area enlarges, becomes inflamed and the tissue is hard to the touch. As the process continues, the affected tissue will slough away exposing underlying tissues. This lesion appears as a hole or ulcer in the skin. The open wound may range in size from a thumbnail to the size of a hand. The healing is very slow and full recovery takes several months. Scarring is common, and some people require plastic surgery and skin grafts.

Ohio State entomologists recommend collecting the spider, if possible, for positive identification because early treatment after a bite by a brown recluse is indicated. While effective antivenom is not available, the doctor usually administers high dosages of cortisone-type medications to prevent the complications associated with the bites. Several reports suggest that the drug dapsone, which is used to treat leprosy, may reduce the amount of tissue damage that occurs. The use of antiseptic solution to prevent infection and ice packs to relieve local swelling and pain can be initiated immediately after the bite, but a doctor’s visit is in order.

Send your health questions to Debbie Jackson, PhD, MN Clemson University, 302 Sikes Hall, Clemson, SC 29634-5155 or e-mail dbj@clemson.edu.