Brown Recluse Spider Envenomation Workup

Updated: May 16, 2017
  • Author: Thomas C Arnold, MD, FAAEM, FACMT; Chief Editor: Joe Alcock, MD, MS  more...
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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.

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Other Tests

Several groups are currently developing laboratory methods of detecting brown recluse venom or venom components in tissue around the site of the bite. [10] One study suggests that exposure of red cells to brown recluse venom reduces their levels of glycophorin A; measurement of glycophorin A by flow cytometry may help identify exposed patients. [1] Once the technology to identify this venom in patients becomes readily available to the clinician, the ability to study this envenomation will burgeon.

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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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