Monday, May 14, 2007

Spider Bite

"Do you think I need to see a doctor about this?"

I hesitated briefly and my sister, also a nurse, jumped in, "Yes! That's ugly."

Ugly is an understatement. It was about 3cm (1.5 inches) across and elevated by nearly a half inch. Fiery red with a scabbed center, my hesitation was not about whether it should be seen, but how soon. ER or private physician?

"How long has it been there?"

"Yesterday. The spider bit me yesterday. It itched and I scratched it."

We also learned that it had oozed a thick, white, substance that was described as resembling yogurt. We learned that the pain was quite localized in the area of the lesion which had doubled in size since the previous day AND that the person had NO intention of changing plans for the evening which did not include the ER. I hope it doesn't do more than double again before it's treated.

I'm betting on CA MRSA - community acquired methicillin resistant staph aureus. Nasty bug, that one, and increasingly common. I hope I'm wrong. Better that than a brown recluse spider bite, though. Those cause significant tissue damage. The person did not think the bite was from a brown recluse, just a fairly large house spider and that it got infected after being scratched. If there had been a necrotic center, I'd have pushed for an ER visit that evening, but it was scabbed over, not necrotic, and not oozing.

In case you're curious, here are some links to MRSA infections and nasty spider bites:
Warning, they're all ugly.

Brown recluse bite -- note the necrotic area in the center. It's red, but not elevated.

Another brown recluse bite -- really ugly one on a hand. As an anonymous person says in the comments, this may or may not actually be a brown recluse bite. If it is, it's likely infection that has done most of the damage rather than brown recluse venom. Check out this link (no pictures) on the UC Riverside entomology site.

MRSA skin abcess -- very similar to the abcess I saw, but with no center scab -- and a little smaller

Spider bites can get infected, whether they're from a dangerous spider like the brown recluse, or a house spider. It is also possible, and doubtless more common, to have an infected hair follicle, or other skin lesion. The link above to the article about CA-MRSA includes a list of risk factors for otherwise healthy people which includes "close skin-to-skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions, and poor hygiene."


Dr. Momentum said...

This post really calls for a photo.

Don't some spider bites cause necrosis? That alone would send me to the ER. Oozing would make me flip out.

I guess I'm a wimp when it comes to that sort of thing.

Judy said...

You're right. A picture would be nice, but I didn't have a camera handy at the time. I should link an image. I've seen some on line that look just like this one.

Brown recluse spider bites cause necrosis - so do some others. The person didn't think this was a brown recluse because there wasn't a central area of necrosis, just a scab. If there had been necrosis, I'd have tried to get the person to go to the ER. My husband had a lesion on his leg that looked like a typical brown recluse bite -- white with red around it that progressed to central necrosis with a rapidly expanding red ring. No elevation. Really ugly. I dragged his butt to the local urgent care because his doctor's office was closed.

Anonymous said...

the second picture is fake, i jsut looked it up, and it is not a proven brown recluse spider bite picture at all.

also, unless you live in the sounth east, it is definately not a brown recluse. also, it is misdiagnosed so freqently that no one is actually sure exactly how many documented cases of bites there are.

heres a link to inform you of brown recluses.

dianatreine said...

my husband was bitten by a spider, at least we assumed it was a spider. He went to ER and spent 4 days in the hospital. They tested his blood and the white count was very low and I was wondering if anyone else had a similar experience.

Judy said...

The picture isn't fake. It's unproven. Those are not the same thing. It may or may not be a brown recluse bite, but even if it is, infection is the most likely cause of most of the damage.

Also, south east is not the location of brown recluse spiders, according to the UCR web site you referenced. South Central -- gulf coast, much of the Mississippi valley, and parts of the Southwest are recluse spider ranges.

Thanks for the link. It was interesting and informative and I've added it to the post.

Anonymous said...

those pics were so disgusting and i've seen MRSA first hand it gets worse. it can get up to the size of a baseball no lie. my mom had to have surgery on her leg becucause of how big hers got. everyone should be more aware of MRSA.

kitiara k said...

my little brother has the same thing on his elbow that is in the first picture shown. its a lot bigger and a lot worse. none of the doctors around here know what it is or know what to do about it. can someone please give me advice?? they are going to start him on treatment and the pills he has to take could kill him, this is NOT a joke. please help us. -kitiara

Judy said...

Blogs really aren't the place to get medical advice. If you want another medical opinion, I suggest that you take your brother to a major medical center for evaluation.