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Spider Envenomation, Brown Recluse: Differential Diagnoses & Workup
Updated: Aug 18, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Other Problems to Be Considered
Cutaneous anthrax
Community-acquired MRSA skin infection
Pyoderma gangrenosum
Workup
Laboratory Studies
- Wound cultures and Gram stain may provide valuable information for local wounds.
- If signs of systemic toxicity are present, monitor the patient for evidence of hemolysis, renal failure, and coagulopathy.
- If treatment with dapsone is being considered, obtain a glucose-6-phosphate dehydrogenase (G-6-PD) level before treatment.
Procedures
- Conservative local debridement of necrotic lesions may be performed once the wound margins have been defined. Wide excision is disabling, disfiguring, and seldom indicated.
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Differential Diagnoses & Workup: Spider Envenomation, Brown Recluse |
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References
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Rees R, Campbell D, Rieger E, King LE. The diagnosis and treatment of brown recluse spider bites. Ann Emerg Med. Sep 1987;16(9):945-9. [Medline].
Sams HH, Hearth SB, Long LL, Wilson DC, Sanders DH, King LE. Nineteen documented cases of Loxosceles reclusa envenomation. J Am Acad Dermatol. Apr 2001;44(4):603-8. [Medline].
Vetter RS, Barger DK. An infestation of 2,055 brown recluse spiders (Araneae: Sicariidae) and no envenomations in a Kansas home: implications for bite diagnoses in nonendemic areas. J Med Entomol. Nov 2002;39(6):948-51. [Medline].
Vetter RS, Bush SP. Reports of presumptive brown recluse spider bites reinforce improbable diagnosis in regions of North America where the spider is not endemic. Clin Infect Dis. Aug 15 2002;35(4):442-5. [Medline].
Wille RC, Morrow JD. Case report: dapsone hypersensitivity syndrome associated with treatment of the bite of a brown recluse spider. Am J Med Sci. Oct 1988;296(4):270-1. [Medline].
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Further Reading
Keywords
Loxosceles reclusus, brown recluse spider, fiddleback spider loxoscelism, necrotic arachnidism, dermonecrotic arachnidism, spider bite, brown recluse bite, envenomations, Loxosceles laeta, morbilliform rash, disseminated intravascular coagulation, DIC, renal failure, seizures, coma, eschar, spider envenomation
Differential Diagnoses & Workup: Spider Envenomation, Brown Recluse