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with Rod Moser, PA, PhD

Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

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Wednesday, March 22, 2006

Spider Bites – Not all are Itsy-Bitsy

We share this planet with many different creatures, and some of them bite (including our own species, but that is another blog). Animal bites are listed among the more common reasons that people seek medical care or advice, and my practice is no different.

High on the list of biters, and certainly high on the fear factor list, is spiders. First, the bad news: It has been estimated that there are about 20,000 species of venomous spiders that live in the United States. Non-venomous Tarantulas are now popular pets among strange people (my opinion). If you add in visiting spiders from abroad that hide in your luggage or stowaway on banana boats, there are more alien species out there. Since our WebMD members are from all over the world, you have my sympathy. I saw a spider in Australia the size of a bird! And, as much as I would like to float down the Amazon, there are spiders there that nightmares are made of.

Now, the good news: Most American spiders lack the fangs capable of penetrating our tough skin or to produce a poison strong enough to cause harm to humans. There are two spiders in particular that can cause some serious harm…even death. The most well-known of these spiders is the infamous Black Widow (there is also a Red Widow and a Brown Widow). Personally, I don’t like to get close enough to determine their current marital status. The other is the Brown Recluse spiders. Both of these nasty arachnids can cause a painful bite, tissue damage, and even death. Most serious and rare, fatal reactions occur in curious people who live closest to the ground. I am talking about children.

Getting a true description of the biter is important since there will not be a police line-up. The Black Widow is a glossy-black spider about the size of a quarter (counting those eight legs). They have an hour-glass shaped marking on the bottom of their abdomen, usually red or orange. They love living in piles of firewood, under steps, or in dark garages and basements. They have an attitude not unlike my first-grade teacher, and will bite with little provocation. They will not chase or hunt you down, however. The Brown Recluse is smaller and brown, of course, with a violin-shaped marking on the back, hence their other name, the Fiddle Back Spider. Personalities of individual spiders vary, just like people, but you don’t want to mess with “The Fiddler”.

If you or your child encounters a harmless spider, leave it alone. Personally, I try and kill the poisonous ones that I find near the house or play areas. I hope this does not offend the Buddhists or PETA, but I am not brave enough to develop a capture and release program or try and rehabilitate them against biting me or my grandchildren. I pay the mortgage. They are squatters, so they gotta go. Yes, I believe that all of God’s creatures have a right to live, but just not under my stairs.

If you are bitten by a spider that is not on the bad list, you will most likely just get a painful, itchy red spot, not unlike an ant or insect sting. Even some Black Widow or Recluse bites may not cause more than a painful, local reaction. If the spider is having a particularly good day and you are lottery-lucky, it may not inject venom. These two venomous spiders produce a bright red bump within a few hours that will evolve into some local tissue damage called necrosis. The surrounding skin may be purplish-black and eventually ulcerate – a nasty-looking wound that can take months to heal. It may even leave a permanent scar as a reminder of your close encounter. Tissue damage from a Brown Recluse may even require plastic surgery or a skin graft.

A Black Widow envenomation will cause systemic reactions – muscle cramps, abdominal pain and rigidity, rapid heart rate, sweating, nausea, vomiting, or, in my case, screaming like a little girl. Because Black Widow spider bites have the potential to kill this is a true emergency. It is 911 and Emergency Room time. Children can have a mortality rate as high as 50%, so this is not something to procrastinate about. Antivenin is available for Black Widow bites, and it should be administered promptly. There is no antivenin for the Brown Recluse, but there is emergency treatment.

Have I sufficiently frightened you? I bet that I am going to have some good dreams tonight…

Related Topics: Preventing Poisoning in Young Children, Kids Vulnerable to Medicine Mishaps

Technorati Tags: spiderbites, blackwidowspider, brownreclusespider

Posted by: Rod Moser, PA, PhD at 8:56 am

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