Brown Recluse Envenomation - Symptoms, Stages, and Treatment

Introduction

Only a few of the 40,000 spider species discovered can harm humans. Most spiders do not even bite without being provoked. And if they do, most of them lack fangs that are long and strong enough to penetrate human skin and cause serious problems. Every spider has a poison gland that secretes venom into a venom sack. However, unless provoked, they do not bite a human; they are more likely to hide from a human than bite a human. A few species of spiders could harm humans, like the black widow, brown recluse, etc.

Although reports of brown spider bites causing severe tissue damage and even necrosis (tissue death) can be found as early as 1872 in the United States, the brown recluse spider, Loxosceles reclusa, was not identified as the likely culprit until 1957. The brown recluse spider is now one of the most medically significant spiders. It is one of the few spiders we encounter that can not only bite humans but whose venom can cause serious wounds and poisoning.

What Is a Brown Recluse Spider?

The brown recluse spider is an arachnid with eight legs and a violin marking on its back that can range from a quarter to half an inch long. Younger spiders or spiders that have just molted will not have the violin marking. Although the violin-shaped marking is easily identified, the brown recluse spider's most distinguishing feature is its eyes. The brown recluse spider has six eyes; unlike other spiders with eight, they are arranged in three pairs in a semi-circular row.

Where Does the Brown Recluse Spider Live?

• Brown recluse spiders are common in the southeastern and midwestern United States. It prefers warm, dry, and dark environments. It can be found outdoors near rocks, utility boxes, woodpiles, and under the bark.

• Brown recluse spiders can live indoors, anywhere that has not been disturbed. So they can be found in boxes, unworn clothing and shoes, home corners, and crevices like an attic, crawl space, basement, or closet.

What Are the Signs of a Brown Recluse Spider Bite?

The venom of the brown recluse spider is capable of destroying human tissue. When the bite occurs, the victim may not feel or notice it. The bite site may initially appear like any other insect bite - red, itchy, and inflamed. However, the venom destroys the surrounding tissues over a few days. Symptoms of the bite of a brown recluse spider include:

• Initially painless, but later becomes red and painful.

• Loxoscelism syndrome, wherein the area around the bite becomes dusky, and open sore forms as the skin around the bite dies.

• Swelling and redness around the bite, white blisters surrounded by a reddish-purple ring, bull's eye-like appearance.

• Pus-filled blisters.

• Joint stiffness.

• Fever.

• Chills.

• Body rash.

• Nausea and vomiting.

• Body ache.

• Restlessness.

• Dizziness.

• It can even cause serious complications like coma, blood in the urine, seizures, kidney failure, etc.

What Are the Stages of a Brown Recluse Spider Bite?

1. Hours After a Bite

• The area becomes sensitive and red about three to eight hours after the bite.

• The bite site starts to experience a burning sensation.

• The bite site's color changes. It can have a bullseye appearance or bruise and be blueish.

2. Three to Five Days Following a Bite

• The pain should go away immediately if the spider injects a small amount of venom.

• If the venom spreads beyond the bite site, discomfort may last for several days, and an ulcer may form on the bite site.

3. Seven to 14 Days After a Bite

• In severe cases, the skin around the ulcer degrades and becomes a wound that may take months to heal completely.

4. Three Weeks After a Bite

• Most bites will heal in three weeks.

• A thick, black scab will cover the wound.

How Is a Brown Recluse Spider Bite Managed and Treated?

If a brown recluse has bitten one, go to the emergency room or call a doctor immediately. If possible, catch and carry the spider in a jar along. This will help the doctor identify the spider and confirm the diagnosis. A tetanus booster is frequently administered in the emergency department.

First aid before reaching the hospital includes:

• Wash the bite area thoroughly with soap.

• To reduce swelling, apply a cold, damp cloth or an ice pack to the bite area.

• Elevate the spider-bitten leg or arm.

• Do not attempt to extract the venom.

• Take a pain reliever or an antihistamine (allergy medication) to relieve swelling and itching.

The majority of bites respond to rest, ice, and elevation. Various treatments and medications have been used to treat skin complications caused by a bite. However, studies have shown that none of these treatments are reliable and effective. Among the most frequently used are:

• Colchicine.

• Corticosteroids.

• Dapsone.

• Diphenhydramine.

• Hyperbaric oxygen.

• Nitroglycerin.

• NSAIDs (non-steroidal anti-inflammatory drugs), such as Ibuprofen.

• Pain relievers.

If the bite wound becomes infected, the doctor may also prescribe antibiotics.

How to Avoid Brown Recluse Spider Bites?

Unless provoked, most spiders do not bite. Spider bites can be avoided by:

• Learning about the various types of spiders and their habitats.

• Use insect repellents approved by the EPA (environmental protection agency).

• While cleaning basements, sheds, and other crawl spaces, wear long-sleeved clothing, boots, and other protective gear.

• Examine clothes and boots before putting them on.

• Remove spider webs.

• Keep no piles of wood, leaves, or rocks near the house.

• Maintain a safe distance between the bed and the wall.

• Keep items in the storage room in closed or taped covers or boxes in the storage room to prevent spiders from crawling into them.

• Take care when removing items from storage left undisturbed for an extended period.

Conclusion

Brown recluse spiders are harmless unless provoked. If provoked, they bite, and their venom can be potentially harmful to humans. When the bite occurs, the person may not feel or notice it. The bite site may initially appear red, itchy, and inflamed. However, the venom destroys the surrounding tissues over a few days. Most bites resolve in a few days with first aid management; if they do spread, medications can help resolve the issue.