Brown Recluse Spider Bites to the Head: Three Cases and a Review

Consequences of envenomation from the bite of a brown recluse spider (Toxosceles reclusa) range from mild itching to death. The bite of this spider causes the most severe form of arthropod-induced tissue necrosis. These bites pose several challenges to the clinician in that diagnosis can be difficul...

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Bibliographic Details
Published in:Ear, nose, & throat journal nose, & throat journal, 2004-07, Vol.83 (7), p.465-470
Main Authors: Leach, Joseph, Bassichis, Benjamin, Itani, Kamel
Format: Article
Language:English
Subjects:
Bites and stings
Care and treatment
Female
Health aspects
Humans
Loxosceles reclusa
Middle Aged
Phosphoric Diester Hydrolases - poisoning
Properties
Spider Bites - pathology
Spider Bites - therapy
Spider venom
Spider Venoms - poisoning
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Summary:Consequences of envenomation from the bite of a brown recluse spider (Toxosceles reclusa) range from mild itching to death. The bite of this spider causes the most severe form of arthropod-induced tissue necrosis. These bites pose several challenges to the clinician in that diagnosis can be difficult, systemic manifestations can occur, and healing can be resistant to conventional measures. Bites to the head and neck—particularly the face—are uncommon, and they have not been widely reported in the otolaryngology literature. As experts in facial soft tissue, otolaryngologists and facial plastic surgeons should be able to recognize and treat these lesions. Because no laboratory test is available to identify the cause of symptoms in these cases, the diagnosis is made clinically. Early intervention can make a significant difference in cosmetic outcome, so a high index of suspicion is warranted. Local wound care includes rest, ice, compression, and elevation of the affected part of the body. Drug therapy with dapsone may limit the severity of the bite and prevent complications. Because some bites cause systemic loxoscelism, clinicians should be familiar with its manifestations. When necrosis occurs despite adequate medical treatment, reconstructive procedures should be delayed until healing is complete. We report 3 cases of brown recluse spider bites to the head. These cases illustrate the broad spectrum of the disease course, and they highlight the therapeutic challenges that these lesions pose.
ISSN:0145-5613
1942-7522
DOI:10.1177/014556130408300712