Escharotic Lesion After a “Brown Recluse Spider Bite” – Photo Quiz

JASON W. MITCHELL, MD, and JEFF DANSKA, PA-C, University of New Mexico School of Medicine, Albuquerque, New Mexico

Am Fam Physician. 2007 Jun 15;75(12):1841-1842.

A 63-year-old woman presented with what she thought was a brown recluse spider bite received 10 days earlier. After noticing a small, painless, nonpruritic, red bump on her upper back, she surmised that a spider had bitten her, although she did not see a spider at the time. The following day she applied a “black salve” she had learned about in a local traditional medicines class. A black eschar soon developed, and the lesion became progressively pruritic.

Her medical history was remarkable for a basal cell carcinoma, excised from a separate location on her back seven years ago, and for well-controlled psoriasis. The physical examination revealed a 1-cm concentric black eschar surrounded by a 2-mm fissure and a 4-mm ring of erythema (see accompanying figure) on her upper back.

Question

Based on the patient’s history and physical examination, which one of the following is the most likely diagnosis?

A. Brown recluse bite.

B. Cutaneous anthrax.

C. Ecthyma.

D. Reaction to black salve.

E. Recurrent basal cell carcinoma.

Discussion

The answer is D: a reaction to black salve. Black salve is an escharotic compound typically containing bloodroot (Sanguinaria canadensis). Traditionally, it is used by Native Americans as an orange dye and herbal medicine. It was first described in the 1800s as a topical salve used to treat breast cancer and other solid tumors.1 Although recent laboratory studies suggest potential future applications, no clinical data currently support its use for cancer treatment.2 However, it has been used in the past as part of the Mohs surgical technique as a chemical fixative before the procedure. 2,3

Bloodroot contains sanguinaria, a toxic alkaloid with antimicrobial, antifungal, and anti-inflammatory properties.1,4,5 Toxic alkaloids are corrosive, causing tissue necrosis and formation of a black eschar.6 Exaggerated curative properties of bloodroot are advertised on products and Web sites.

Approximately 80 percent of reported “spider bites” are caused by nonarachnid sources.7 The tissue necrosis visible in the accompanying figure could be consistent with a brown recluse spider bite; however, the clinical history and onset of symptoms are not. The typical brown recluse bite is painful and associated with development of a lesion within 10 minutes. Infarction at the site presents as a sinking blue macule; surrounding erythema develops two to eight hours later. Forty percent of these bites result in central necrosis, and 20 percent develop severe necrosis.8

Cutaneous anthrax develops as a result of Bacillus anthracis spores entering the body through mucous membranes or breaks in the skin. Average rates in the United States were less than one case per year before the 2001 outbreak. Cutaneous anthrax typically occurs on the arms, face, and neck. A pruritic papule develops within one week of infection and progresses to a 1- to 2-cm vesicle surrounded by nonpitting edema. Rupture and necrosis then occur, followed by a black eschar.

Ecthyma, a type of impetigo, typically begins with discrete vesicles. It is followed by erosion, ulceration, and finally an asymmetrically shaped eschar. This process results from dermal extension of the infection, causing a vasculitis.

Basal cell carcinoma is a malignant tumor of the skin originating from basal cells of the epidermis. It typically begins as a smooth, pink to red nodule with pearly borders. Ulceration and crusting occur with enlargement. This occurs over a longer period than described in this case.

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Selected Differential Diagnosis of a Black Eschar

Selected Differential Diagnosis of a Black Eschar

Spider bites | DermNet NZ

Author: Vanessa Ngan, Staff Writer, 2006.

Introduction

Spiders belong to the class of mainly terrestrial arthropods known as Arachnida. Medically significant classes of arachnids include spiders, ticks/mites and scorpions. Unfortunately through myths, legends and nowadays media, spiders have gained a reputation of being dangerous and harmful, and in some people instil a psychological fear known as arachnophobia. In reality, very few are dangerous to man and media reports exaggerating the dangers of spider bites are far out of proportion to the actual threat they pose.

Necrotic spider bite

Which spiders bite and may be harmful to man?

Latrodectus spp (widow spiders) are found throughout the world and known by many different common names according to country.

• Black widow (North America)
• Katipo (New Zealand)
• Red-back (Australia)
• Shoe-button (South Africa)

Loxosceles spp is found in South America, United States, Australia, and commonly in the tropics.

• Violin spiders
• Recluse spiders
• Brown recluse spiders
• Fiddleback spiders

Tegenaria agrestis (hobo spider) and Cheiracanthium (yellow sac spider) are found in the United States.

Phoneutria (banana spider) is found in Central and South America.

Atrax and Hadronyche (funnel-web spider) are found in Australia.

The venom produced by spider bites is generally either neurotoxic or cytotoxic. Web dwellers tend to have neurotoxic venom and non-web dwellers cytotoxic venom. Spiders of the Latrodectus genus produce neurotoxic venom, while the violin spider and yellow sac spider produce cytotoxic venom.

What are the signs and symptoms of a spider bite?

The signs and symptoms of a spider bite depend on many factors, these include:

• Neurotoxic or cytotoxic venom
• Amount of venom injected
• The health of the patient (e.g. any allergies)
• Age of the patient (small children and older persons are more adversely affected)
• Site of the bite.

The signs and symptoms from a bite from a spider with neurotoxic venom differ to those produced by a spider with cytotoxic venom. The severity of the symptoms depends on the species of the spider as the symptoms of bites from different species of Loxosceles can range from unremarkable (requiring no care), localised (usually self-healing), dermonecrotic (slow-healing ulcerated lesion requiring treatment), to systemic (vascular, renal damage and sometimes life-threatening).

Features of neurotoxic venom bite

• Affects neuromuscular junctions
• Severe pain in the chest and abdomen (cramp-like pains)
• Breathing difficulties, heart palpitations
• Nausea and vomiting
• Sweating, fever, excessive salivation
• Increased blood pressure
• Rash may develop
• Symptoms usually start about 1-3 hours after being bitten
• More severely affected are children and older persons

Features of cytotoxic venom bite

• Affects cellular tissue and usually restricted to the area of the bite
• Initial bite is painless but symptoms develop about 2–8 hours later, the area becomes painful and swollen
• Eventually, a blister may form over a necrotic lesion which then sloughs to create an ulcerated wound (up to 10cm)
• The ulcer will heal over months and leave behind a scar. In extreme cases, skin grafts may be necessary.
• In severe cases, systemic conditions may occur, such as thrombocytopenia, disseminated intravascular coagulation, renal failure

What are the dermatological features of a spider bite?

Widow spider bite

The skin around the site of the bite is red and two fang marks may be visible where the skin was penetrated. In untreated cases, a rash may develop after several days. Systemic symptoms are of more diagnostic value.

Violin or recluse spider bite

The dermatological features of these spider bites depend on the severity of the bite. In self-healing wounds, the bite site gets no worse than being swollen and red. With more serious bites a “bull’s eye” wound may form. This is characterised by a central red swollen blister that is separated from a peripheral bluish region by a white zone of firm swelling. If the bite turns a purplish colour within the first few hours, this usually indicates severe localised tissue death (necrosis) may occur. Over days the blister forms a scab, which hardens and falls off to leave behind an ulcerated depression. Healing can take weeks to months.

Interestingly, it appears that bites that become systemic do not also develop necrotic wounds. It is thought that in necrotic wounds the venom is localised in the tissue whereas in systemic reactions the venom is distributed quickly throughout the body without any localised effects.

Another spider bite

• Hobo spider results in dermonecrotic lesions similar to violin/recluse spider bites.
• Yellow sac causes a painful, red, swollen and itchy bite that may produce a slightly necrotic wound that heals without scarring.
• Banana spider has few dermatological features, mainly neurotoxic symptoms.
• Funnel-web causes sudden onset of neurotoxic symptoms, and the dermatological features insignificant in comparison.
• Whitetail spider may cause discomfort and redness but does not cause ulceration or any serious symptoms.

Do spider bites cause bacterial infection?

Although many people attribute an episode of bacterial infection (especially cellulitis and necrotising fasciitis) to an unseen spider bite, they are falsely blamed. Documented spider bites have not led to skin these infections.

What is the treatment for a spider bite?

One of the most important aspects in treating spider bites it to try and identify the offending spider. The venom of spider bites is quite variable hence identification of the spider can be of value in determining the management of the condition.

General measures that should occur after a spider bite include:

• • • Wash the area well with soap and water
    • Apply a cold flannel or ice pack wrapped in a cloth to the site
    • Give paracetamol for pain
    • Seek immediate emergency care for further treatment.

Depending on the identification of the offending spider and the severity of the bite, treatment may include:

• • • Muscle relaxants
    • Stronger pain relievers
    • Antihistamines to reduce swelling
    • Antibiotics for confirmed secondary infection
    • Supportive care
    • Antivenin.

Specific treatment for bites from certain spiders include:

• • Antivenin is available for bites by spiders of the Latrodectus and Loxosceles genera and is very effective if given soon after the bite.
  • Hydroxyzine (antihistamine) may be given to alter the necrotic lesion of bites from spiders of the Loxosceles genus.
  • Intravenous calcium gluconate alternating with methocarbamol to relieve muscle cramps caused by spiders belonging to the Latrodectus genus (e.g. black widow) (controversial).
  • It is possible that systemic steroids may be of benefit.

“Spider Bite” Lesions are Usually Diagnosed as Skin and Soft-Tissue Infections

https://doi.org/10.1016/j.jemermed.2009.09.014Get rights and content

Abstract

Background: Many people seek medical attention for skin lesions and other conditions they attribute to spider bites. Prior experience suggests that many of these lesions have alternate causes, especially infections with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Objectives: This study determined the percentage of emergency department (ED) patients reporting a “spider bite” who received a clinical diagnosis of spider bite by their physician vs. other etiologies, and if the diagnoses correlated with demographic risk factors for developing CA-MRSA infections. Methods: ED patients who reported that their condition was caused by a “spider bite” were prospectively enrolled in an anonymous, voluntary survey regarding details of their illness and demographic information. Discharge diagnoses were also collected and categorized as: spider bite, bite from other animal (including unknown arthropod), infection, or other diagnosis. Results: There were 182 patients enrolled over 23 months. Seven patients (3.8%) were diagnosed with actual spider bites, 9 patients (4.9%) with bites from other animals, 156 patients (85.7%) with infections, and 6 patients (3.3%) were given other diagnoses. Four patients were given concurrent diagnoses in two categories, and 8 (4. 4%) did not have the diagnosis recorded on the data collection instrument. No statistically significant associations were found between the patients’ diagnostic categories and the demographic risk factors for CA-MRSA assessed. Conclusion: ED patients reporting a “spider bite” were most frequently diagnosed with skin and soft-tissue infections. Clinically confirmed spider bites were rare, and were caused by black widow spiders when the species could be identified.

Keywords

Spiders

bites and stings

methicillin-resistant Staphylococcus aureus

black widow spider

arachnidism

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Causes of Necrotic Wounds other than BRS Bites

Causes of Necrotic Wounds other than Brown Recluse Spider Bites

by Rick Vetter

updated October 2004

Throughout the United States, spiders get blamed as the cause of many dermatological wounds in medical diagnoses. In virtually every case, NO spider is seen nor felt inflicting a bite, nor is the alleged spider collected in the incident. “Potential spider bite” diagnoses are made solely on the symptoms of the lesion. In the case of necrotic wounds, “brown recluse spider bite” is a very common conclusion of medical personnel throughout North America including such ludicrously inhospitable places as Canada and Alaska where no brown recluses have ever been found. This is in spite of the fact that the brown recluse spider (Loxosceles reclusa) is native only to the South and central midwestern states (circumscribed by southeastern Nebraska south to Texas, east to Georgia/westernmost tip of South Carolina and southernmost Ohio with additional rare finds being made beyond this area). In addition there are several related species that exist in the southwestern U.S. deserts from Texas to California; however, they do not inhabit the coastal California regions where most of the human population is concentrated. (see distribution map) The members of the genus Loxosceles are known as recluse, violin or fiddleback spiders. Occasional, RARE occurrences of the brown recluse do occur outside this region because of the spider’s proclivity to hide in boxes and the subsequent movement of possessions or commerce from its native area. However, occurrences outside the native areas are still extremely rare and they typically encompass finds of single specimens only, not burgeoning populations of these spiders. When people hear that there are no recluse spiders in their area, many immediately switch to hobo spiders or yellow sac spiders as their “recluse du jour”, but the solid evidence of those spiders being involved is also lacking. People just WANT to blame spiders when there are lots of more probable things that cause necrotic injuries (see below).

When one finds a habitat that is conducive to recluse spider survival, no matter what the species, one does not find single specimens; one finds dozens of them. For example, a family of 4 in Lenexa, Kansas collected 2,055 brown recluse spiders in their house in 6 months. About 450 of these were large enough to cause envenomations, they saw brown recluses crawling all over the house, the walls, the carpet, in the sinks and bathtub, yet in 8 years of occupancy of that house (as of Sept 2004), no person or their multitude of pets has ever shown evidence of a bite (Vetter and Barger, Journal of Medical Entomology, volume 39, pages 948-951, 2002). Other people from endemic recluses areas like Arkansas, Alabama, Oklahoma, Missouri, Texas have written to me with similar stories. In comparison, transported spiders virtually never establish populations after being moved, the numbers of spiders found outside the native area of the brown recluse are very few yet diagnoses of their bites are hundreds and thousand times more plentiful than are verified finds of the spiders. It shouldn’t take a math whiz to realize that the medical community is overdiagnosing brown recluse spider bites. If you truly think you were bitten by a recluse in your home, you should be able to find several specimens in a few days if you look for them. They are NOT hard to find where they prosper.

Please also be aware that far too many people continue to misidentify harmless spiders as brown recluses because they can imagine a violin on the spider. It is not that simple. Many spiders have dark markings on their bodies that look like violins to the non-arachnological public (cellar spiders, Oecobius, Mimetus, etc.) and have been misidentified because of that. Several of these spiders (i.e., Kukulcania, Anachemmis, Titiotus, etc.) do indeed look very similar to recluses so you have to be very careful in assuming that you have identified a spider correctly. It is always best to seek out a qualified arachnologist, who are unfortunately few and far between. Even entomologists, doctors and public health officials who lack training in arachnology have been overconfident of their abilities and have misidentified harmless spiders as recluses. I have even seen specimens from a Texas medical school that were not recluses but were being used to teach medical students what brown recluses look like. Therefore, the med students were getting incorrect information right from the start. I have been identifying spiders that people THINK are or might be brown recluses and have received nearly 1,700 spiders as of October 2004 and they have represented 36 different spider families; basically every genus of medium-sized brown spider found in America has been sent to me as a potential brown recluse.

In regard to diagnoses of “spider bites”, the medical community is overreliant on the brown recluse as the causative agent of these wounds in many portions of the United States. In South Carolina, 940 physicians responding to a survey reported 478 brown recluse spider bites in their state in 1990; in stark contrast, the definitive scientific study on the distribution of all recluse spiders in the U.S. lists only 1 brown recluse from South Carolina. Recently, I have heard of several verifications of brown recluses in the westernmost tip of South Carolina around Greenville but they are virtually non-existent in the remainder of the state. In a 6-year database for the 3 Florida poison control centers, 124 brown recluse spider bites from 31 counties were diagnosed by medical personnel in that state (this is only a small portion of the actual number of diagnoses made). In comparison, in 100 years of arachnological information totaling over 100,000 identified spiders, only 11 finds of recluse spiders have been found in 10 counties and only 2 of these finds were in homes. In a study published in October 2003, four western U.S. arachnologists were contacted in regard to 216 brown recluse spider bite diagnoses made in California, Oregon, Washington and Colorado in 41 months. In contrast, only 35 brown recluse or Mediterranean recluse spiders could be verified as EVER being found in these 4 states. None of these 35 spiders was involved in an envenomation and in the 67 years of our collective experience, not one “recluse bite” victim has ever submitted a brown recluse to us for identification. In contrast, homeowners from endemic recluse areas submit brown recluses for identification about 70% of the time and people with necrotic skin lesions submit a recluse spider about 10% of the time. What should be becoming apparent to you is that 1) recluses spiders are common where they are found, 2) you need decent populations of them before you get a significant probability of a bite from one and 3) doctors from non-endemic areas are diagnosing bites from these spiders far out of proportion to the actual number of spiders that can be historically found in their states.

Medical personnel will diagnoses “brown recluse bite” because that is the most common and, unfortunately, most dynamic cause of necrotic wound that they have read about. Below is a list of skin afflictions that have been misdiagnosed as “brown recluse bite” by medical personnel. This list is published in the following Toxicon article and can be referenced as such. The second publication is a similar paper which details the overdiagnosis aspect in Florida. If you wish a copy of either or both of these articles, contact me and I will send one to you electronically in PDF form or as a paper copy.

• Vetter, R. S., P. E. Cushing, R. L. Crawford and L. A. Royce. 2003. Diagnoses of brown recluse spider bites (loxoscelism) greatly outnumber actual verifications of the spider in four western American states. Toxicon 42:413-418.
• Vetter, R. S., G. B. Edwards and L. F. James. 2004. Reports of envenomation by brown recluse spiders (Araneae: Sicariidae) outnumber verifications of Loxosceles spider in Florida. Journal of Medical Entomology 41: 593-597.

Conditions that have been misdiagnosed as brown recluse spider bites as reported in the medical literature

Bacterial	Reaction to drugs
Staphylococcus infection Streptococcus infection gonococcal arthritis dermatitis cutaneous anthrax
Viral	Arthropod-induced
infected herpes simplex chronic herpes simplex varicella zoster (shingles)	Lyme disease Rocky Mountain spotted fever Ornithodoros coriaceus bite (soft tick) insect bites (flea, mite, biting fly)
Fungal	Topical
sporotrichosis keratin cell mediated response to fungus	poison ivy/poison oak chemical burn
Lymphoproliferative disorders	Underlying disease states
lymphoma lymphomatoid papulosis
Vascular disorders	Misc. /Multiple causative agents
focal vasculitis purpura fulminans thromboembolic phenomena polyarteritis nodosa	pyoderma gangrenosum pressure ulcers Stevens-Johnson syndrome erythema multiforme erythema nodosum toxic epidermal necrolysis (Lyell’s syndrome)

One of the more pertinent causes listed here is that the expression of Lyme disease can give the classic bulls-eye patterning characteristic of brown recluse bite. Misdiagnosis in this case can be rather disconcerting because Lyme disease can be treated and cured with common antibiotics. If diagnosed as brown recluse bite instead, it will obviously be treated as such and then the Lyme disease can progress into more serious symptoms of heart and central nervous system disorders. I have already helped one person in Rhode Island get away from his doctor’s misdiagnosis of brown recluse bite (the closest native populations of recluse Rhode Island is southernmost Ohio) and on Lyme disease, which is what it was. In treating alleged spider bite victims, a question that medical personnel should also be asking is whether the patient has recently traveled outside the area where they live in case the patient might have been exposed ticks. Another consideration is being aware of potentially embarrassing etiologic agents such as filthy lifestyle habits (squalid conditions that might encourage vermin such as bed bugs).

If you have been diagnosed as having a brown recluse bite and you do not live within the native range of any recluse spider (see the map http://spiders.ucr.edu/images/colorloxmap.gif ) then there is minimal chance that your wound was caused by a recluse spider.

Finally, many people have contacted me and explained in detail the progression of their wounds.   Considering that the medical profession continues to misdiagnose skin conditions all the time and they see the wounds in person, there is little chance that I am going to be able to provide much more information from your written description over the internet other than the information I offer below.

1. If you do not live in areas that are known to have recluses, then there is little chance of having a recluse bite. People constantly try to justify recluse bites because they have traveled recently or receive shipments from recluse-endemic areas. Although this is a logical consideration, in reality it has a very little chance of being the actual cause otherwise, arachnologists would constantly be finding recluses outside the endemic area. It just doesn’t happen that often to justify bite considerations. If you print out this website, try to educate your doctor and he/she refuses to listen to your concerns of alternative diagnoses, find another doctor who is more willing to be educated or who already knows there are no recluses in your area.
2. If there are multiple wounds in one person at once, or multiple wounds over a period of time, or multiple victims in a house, it is probably not a recluse bite. Multiple wounds are more likely the work of insects (fleas, kissing bugs) or arachnids (mites, ticks) that are seeking you for a blood meal or it is some underlying dermatologic condition (Staphylococcus infection, pyoderma gangrenosum). Please don’t ask me what insects it might be, I don’t know much about them. It will be best to ask your local entomologists or public health officials what biting insects are in the area. They vary greatly by region.
3. Prisons, jails, correctional facilities, sports camps, military barracks, hospitals, nursing homes, long-term health care facilities – I get contacted every year by many prisons and other correctional facilities where the inmates are complaining that they are being bitten by brown recluses.  Yet when pest control personnel go in, they never can find the spiders.   I have been contacted by prisons in San Francisco, Los Angeles, San Diego, Ohio, Texas, and Arkansas.  The “bite victims” number from a few dozen to low thousands and sometimes include prison guards.  Yet no spiders.  In most of the cases so far, it has been determined that the cause was a contagious bacterial infection.  When officials started treating the condition with the proper antibiotics (e.g. clindamycin) as well as instituting changes of  more frequent hand washing and showering, more changes of clothes and bed linens, the condition came under control.  In the Ohio prison where an inmate died, it was determined that the source of the bacterial spread was crude tattooing being done with contraband needles.  Hospitals and military facilities are also places ripe for bacterial infections which are blamed on spiders because, similar to prisons, people are present up to 24 hours a day in close quarters.  One of the bacterial infections getting more attention now is MRSA (methicillin-resistant Staphylococcus aureus).   See article by Dominguez in references.
4. General practitioners often go to the “brown recluse bite” diagnosis as a causative agent when they have little proof that a spider is involved.  The best thing to do is go to a dermatologist when the wound is fresh so he/she can do a biopsy on the tissue while it is being attacked.  When things start to scar over and heal, it is more difficult to assess the proper condition.  Physicians indeed have a difficult job in identifying skin lesions and in general, they do an amazing job in healing people.  However, they are not helping matters by diagnosing brown recluse bites from areas of the country where brown recluses are exceedingly rare.  From a decade plus of experience, I have found that doctors from endemic areas are much more conservative in diagnosing recluse bites because they know how rare bites actually are and they see real recluse bites occasionally.  In comparison, doctors in non-endemic areas will diagnose several recluse bites in a month, more recluse bites than spiders have ever been found in their entire states.

References:

Spider Bites – Injuries; Poisoning

Most bites leave minimal residual scarring but some can leave a large tissue defect, which may involve muscle. Loxoscelism, a venom-induced systemic syndrome, may not be detected until 24 to 72 hours after the bite and is uncommon but more prevalent in children and adolescents. Systemic effects (eg, fever, chills, nausea, vomiting, arthralgias, myalgias, generalized rash, seizures, hypotension, disseminated intravascular coagulation, thrombocytopenia, hemolysis, renal failure) are responsible for all reported fatalities.

Widow spider bites usually cause an immediate, sharp, stinging sensation. The pain may be described as dull and numbing and may be disproportionate to the clinical signs. Within 1 hour after envenomation, there may be progression to persistent local pain, diaphoresis, erythema, and piloerection at the bite site. Sometimes remote and/or systemic symptoms develop.

Widow spider envenomations are graded as mild, moderate, or severe.

• Mild: Pain restricted to the bite site, normal vital signs

• Moderate: Diaphoresis and piloerection in the area of the bite, cramping pain in large muscle groups of the trunk, normal vital signs

• Severe (also called latrodectism): Diaphoresis at a remote site; intense generalized cramping pain in large muscle groups of the trunk; hypertension and tachycardia; often headache, nausea, and vomiting

Latrodectism, a systemic syndrome caused by neurotoxic venom components of widow spider bites, manifests as restlessness, anxiety, sweating, headache, dizziness, nausea, vomiting, hypertension, salivation, weakness, diffuse erythematous rash, pruritus, ptosis, eyelid and extremity edema, respiratory distress, increased skin temperature over the affected area, and cramping pain and muscular rigidity in the abdomen, shoulders, chest, and back. Abdominal pain may be severe and mimic acute surgical abdomen, rabies, or tetanus. Symptoms tend to resolve over 1 to 3 days, but residual spasms, paresthesias, agitation, and weakness can last weeks to months.

Tarantula bites are extremely rare and nonvenomous with North or South American (“New World”) tarantulas. However, agitation of the spider may cause it to throw needle-like hairs. The hairs act as foreign bodies in skin or eyes and can trigger mast cell degranulation and an anaphylactoid reaction (eg, urticaria, angioedema, bronchospasm, hypotension) in sensitized people, usually pet owners who handle the spider daily. Tarantula species native to non-American continents (“Old-World” tarantulas) are occasionally kept as pets. They are more aggressive than New World tarantulas, lack needle-like hairs, and can be venomous.

(PDF) “Spider Bite” Lesions are Usually Diagnosed as Skin and Soft-Tissue Infections

The lack of any significant association between the

risk factors for CA-MRSA and the incidence of a diag-

nosis of infection probably results from this study being

underpowered to detect such associations. The incidence

of infection was very high whether these factors were

present or not, and many more subjects would be re-

quired to potentially obtain statistically significant results

in this regard.

CONCLUSION

Patients ascribe a large variety of medical conditions to

spider bites. The most common clinical diagnosis

reached by ED physicians evaluating patients with a

complaint of “spider bite” in this study was a skin or

soft-tissue infection. Many of these infections were be-

lieved to have been caused by CA-MRSA. Part of the

reason for the misattribution of these skin infections to

spider bites probably results from the appearance of the

typical lesion induced by CA-MRSA, which is an ery-

thematous, indurated area with central dermonecrosis.

Whether warranted or not, dermonecrosis is commonly

associated by laypersons and health care personnel alike

with spider bites, and thus the lesion is blamed on a

spider, even in the absence of corroborating historical

data.

Acknowledgments—The author wishes to thank: all the UC

Irvine Medical Center ED staff who referred patients for

enrollment; members of the Emergency Medicine Research

Associates Program for their hard work, especially Alan

Cantillep, Jennifer Le, Allison Leung, and Judy Truong;

Craig Anderson, PHD for conducting the statistical analyses;

and Rocky Benoit, MD.

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480 J. R. Suchard

A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution

The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe.

1. Introduction

The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans; among them, we should mention the genus Loxosceles. The common morphological features of these spiders are three pairs of eyes (instead of eight), the particular dark spot on the back often violin-shaped, and frequently brown in colour of different shades.

The species Loxosceles rufescens is widespread in the Mediterranean area [1] and thus extends throughout the Italian territory (including Calabria region). It belongs to the Sicariidae family (from the Latin word sicarium meaning murderess, for the toxicity of its venom), Araneae order, and Arachnida class. It is a sedentary spider with nocturnal activity and is often found in dark and little frequented places such as basements, attics, ceilings, and garages. The venom is composed of low molecular weight proteins, proteolytic enzymes, and nonenzymatic polypeptides with a hemolytic-necrotic action (hence the term necrotic arachnidism) causing oedema, necrosis, and deep ulcerations of the affected parts (skin loxoscelism). Frequently at the bite site, after 12–24 hours, a characteristic necrotic lesion forms circled by a bluish area and a whitish ring (shaped like a bull’s eye), which is very painful. It is hard to correlate the severity of the clinical outlook with the individual components of the venom, but, certainly, these are complex molecular mechanisms which involve the host’s response [2]. It has been demonstrated that the venom of the Loxosceles genus is a potent inducer of the inflammatory response mediated by cytokines and lymphocytes [3].

In rare cases, especially for the Loxosceles rufescens, skin necrosis can spread into subcutaneous tissue and underlying muscles developing a systematic toxicity with varying degrees of severity. Mild-moderate systemic effects involve fever, malaise, myalgia, arthralgia, and rash. In severe but fortunately rare forms, 24–48 hours from the bite, hemolysis, rhabdomyolysis, jaundice, acute renal insufficiency up to shock, and disseminated intravascular coagulation can be observed. This is the case of a patient with a rare form of systemic necrotic arachnidism likely caused by a Loxosceles rufescens bite with rapid development.

2. Clinical Case

A woman of 65, obese (BMI = 44.06), with no history of diabetes and allergies but with a mild form of myasthenia gravis (treated only with pyridostigmine po 60 mg every 6 hours), was bitten the evening before hospitalization while cleaning the home cellar by a spider, which, from the description and place where the bite occurred, could probably be identified as the Loxosceles rufescens species. It was not possible to capture the spider. It was also not possible to visit the home cellar, but we had confirmation from local health service of a Loxosceles infestation in neighboring houses.

Initially, the patient did not give much thought to the event given the few or no symptoms but, after the night, early in the morning, given the sharp pain in her right hand, where a bullous lesion had appeared in the middle phalanx of the third finger, accompanied by malaise and fever (38.2°C), she was admitted to a nearby emergency room.

In our Intensive Care Unit, the patient arrived after about four hours owing to the progressive worsening of her general clinical condition. To our observation, after noninvasive monitoring of vital signs, she appeared drowsy (GCS = 8) and tachypneic (respiratory rate = 28/min), with heart rate 90/min and blood pressure = 82/55 mmHg. We could see a circular necrotic skin lesion on the middle phalanx of the third finger of her right hand with erythroderma and oedema of the hand which partially affected the forearm, with strong pain symptoms.

The limb arterial and venous circulation seemed to have stalled, after we performed an ultrasound examination. Telematic support from the National Poison Control Centre in Milan (Italy) confirmed acute necrotic arachnidism from the information provided.

A bolus of saline 30 mL/kg IV, morphine 5 mg IV, and dexamethasone 4 mg were administered to the patient and high flow oxygen via nasal cannula (HFNC) was initiated. Blood tests revealed the following abnormalities: white blood cells 3.3 10³ μL, Hb 4.59 mmol/L, platelets 55.000 10³ μL, INR 1.72, PT 38.2%, aPTT 121 sec., Procalcitonin 92 ng/mL, and glucose level of 10.67 mmol/L. The blood gas analysis showed a severe metabolic acidosis with pH 7.12, lactate 8.4 mmol/L, and HCO₃ 10 mmol/L.

Endotracheal intubation was initiated along with mechanical ventilation in controlled pressure and invasive monitoring of blood pressure and central venous pressure by placement of a central venous catheter with double lumen 14 Fr catheter. Treatment with norepinephrine at 0.15 mcg/kg/min was started as well as dopamine 8 mcg/kg/min; sedation was achieved via ongoing infusion of remifentanil and midazolam. Prophylaxis against tetanus, specific immunoglobulins, and toxoid tetanus were administered to her. A blood and wound pad culture were taken (which turned out negative after) and broad-spectrum antibiotic coverage was started with Meropenem with 1 gr × 3 doses iv in 24 hours and infusion iv of Daptomycin 4 mg/kg in 30 minutes.

About six hours from admission to the ICU, the oedema had spread to part of the arm with the appearance of erythroderma bullosa (Figure 1) and was clearly distinguished from the initial necrotic lesion on the middle phalanx (Figures 2 and 3). Owing to the development of severe rhabdomyolysis (creatine kinase 2994 U/L and myoglobin 2000 ng/mL), the patient underwent CPFA (coupled plasma filtration adsorption). Transfusion of concentrated red cells was performed due to progressive hemolytic anaemia. Diuresis was kept at values of 1.2 mL/kg/min.

About 12 hours from admission, there was a worsening in tissue condition (Figure 4), appearance of refractory shock, and disseminated intravascular coagulation leading to death of the patient.

3. Discussion

There are four categories of Loxosceles bites [4]:(i)Unremarkable (very little damage and self-healing)(ii)Mild (redness, itching, and slight lesion but typically self-healing)(iii)Dermonecrotic (necrotic skin lesion considered by many as the typical reaction)(iv)Systemic or viscerocutaneous (affecting vascular system, very rare, and potentially fatal)The venom of Loxosceles species is composed of a number of proteins, enzymes, and nonenzymatic polypeptides. Phospholipases D are identified as deleterious components of venom involved in noxious activities. This family of enzymes is described as producing choline to generate ceramide-1-phosphate from sphingomyelin (SM), or lysophosphatidic acid from lysophosphatidylcholine, profoundly altering the lateral structure and morphology of the target membrane, since lysophosphatidylcholine also is a substrate for enzymes found in cytoplasmic cell membranes [5].

Phospholipases D interact with cell membranes and other elements in tissue triggering alterations which involve the complement system and activation of neutrophils. More important is the response of host cells to the presence of a complement mediating foreign substance [6].

Painful bites may be noticed immediately and the offending spider may be seen; often, a diagnosis is made in retrospect from a characteristic history and physical examination.

It is now well established that phospholipase D family is the cause for dermonecrotic skin lesions in humans bitten by Loxosceles arachnids and is the main component of the venom responsible for the local and systemic effects observed in loxoscelism. Loxosceles venom is a potent inducer of multiple inflammatory mediating chemokines such as IL-8 and chemokine growth-regulated protein alpha (GRO-alpha) or chemokines including monocyte chemoattractant protein-1 (MCP-1) [7].

In severe cases, cutaneous necrosis may occur and may extend to involve subcutaneous fat and muscle. Systemic effects may develop, usually 24 to 72 hours after bite. Severe systemic effects include fever, chills, myalgia, arthralgia and generalized rash, hemolysis, jaundice, rhabdomyolysis, renal failure, disseminated intravascular coagulation, coma, and shock [8]. In this case, the simultaneous presence of myasthenia gravis, an antibody mediated disease, may have perhaps favored the fulminating evolution of symptoms. Patients with evidence of hemolysis, significant infection, severe systemic effects, or complicated wounds require hospital admission. Various types of treatments have been described for the management of cutaneous and visceral loxoscelism: corticosteroids, dapsone, colchicine, hyperbaric oxygen, blood transfusions, antimicrobials, surgical treatment, vasodilators, antihistamines, anticoagulants, and serum anti-Loxosceles (South America) [9]. Treatment for systemic effects includes support of respiratory and cardiovascular function and hydration [10]. Transfusion may be necessary in patients with severe hemolysis.

Success of therapy depends upon a correct and rapid diagnosis, the volume of the venom injected, and the patient susceptibility to the venom [11].

4. Conclusions

The deaths from spider bites are very rare in the world [12].

In the Mediterranean area, the poisonings by Loxosceles rufescens spider bite are rarely described in the medical literature [13].

So far, no case of death was described due to the bite of Loxosceles rufescens in Europe.

The clinical case described by us was very serious, rapidly progressive, and refractory to any therapy.

Competing Interests

The authors declare no competing interests.

90,000 SPIDER BITES

Almost all spiders are poisonous; it is with the help of the poison that they paralyze and kill their victim. However, only a few of them have poisonous teeth long enough to bite a person. These exceptions include the black widow, brown hermit, and tarantula.

BLACK WIDOW SPIDER BITE

This spider is found all over the world, a red spot (often in the form of an hourglass) on the belly distinguishes the female; it is she who can bite.Spiders have a black, shiny body.

WHAT TO PAY ATTENTION

It is difficult to establish that the victim was bitten by the “black widow”.

• Sometimes the bite feels like a pinprick, but many victims do not notice it at all. Over the next 15 minutes, a dull aching pain occurs in the bite area.

• Pale red bite marks appear.

• Further, muscle stiffness and colic in the abdomen occur if the person has been bitten in the lower body or legs; if the upper body or arms are affected, the shoulders, chest, back are affected.

• Headache, chills, fever may develop! body, severe sweating, dizziness, nausea, vomiting and severe abdominal pain.

WHAT TO DO

1. If possible, catch the spider and specify its type. Even if the spider’s body is crushed, keep it for identification.

2. Wash the bite with soap and water or rub with alcohol

DO NOT apply a pressure bandage, it is ineffective: the poison of the “black widow” acts almost instantly.

3. Place an ice pack over the bite to relieve pain.

4. Get immediate medical attention. There is an antidote for the poison of the black widow. It is especially necessary for children, the elderly, those who suffer from high blood pressure, pregnant women and in cases of severe poisoning.

BROWN HERMIT SPIDER BITE

The Brown Hermit has a violin-shaped silhouette of brown and sometimes purple on its back.

WHAT TO PAY ATTENTION

• In the early stages, the site of the lesion often resembles a bull’s eye: a white area in the center, redness around the edges; it is all limited to a whitish or blue stripe. A blister with redness and swelling appears at the site of the bite after a few hours.

• Pain, rather mild, but at times significant, develops at the site of the bite after 2-8 hours.

• Fever, weakness, vomiting, joint pain and skin rashes may occur.

WHAT TO DO

1. If possible, catch the spider for identification.

2. Gently wash the bite with soap and water or rubbing alcohol.

3. Apply an ice pack to the bite to relieve pain.

4. Get immediate medical attention.

TARANTUL BITE

These are large hairy spiders.There is moderate pain when they bite.

WHAT TO DO

1. Gently wash the bite with soap and water or rubbing alcohol.

2. Apply an ice pack to the bite to relieve pain.

3. Get medical attention.

SCORPION’S BITE

Scorpions resemble miniature lobsters: they have the same claws and a long, upturned tail with a poisonous sting. When they bite, pain and burning instantly occur around the site of the lesion, then numbness or tingling develops.Severe lesions occur only in children.

This may cause paralysis, spasms, or difficulty breathing.

First aid for bites: step by step algorithm of actions

Tarantulas are a genus of large poisonous araneomorphic spiders that belong to the wolf spider family. The preferred habitat for tarantulas is steppes, deserts and other arid areas. However, they can also be found in the forest-steppe zone. In the daytime, spiders hide in vertical burrows, and at night they crawl out to the surface to hunt insects.They use their webs exclusively for covering walls and forming an egg cocoon, and not for weaving trapping nets.

All tarantulas are poisonous to a greater or lesser degree. Their venomous apparatus includes segments of the chelicera, claws, venom-producing glands and ducts. The venom-producing glands are located in the cephalothorax. The ducts of the glands pass through the claws and open on the back of each cusp. When attacked, the muscular membrane of the gland contracts and a transparent oily drop of poisonous substance with a diameter of up to 0 is thrown out.5 mm.

Distinctive features of spider bites

Tarantula bite

A tarantula bite is similar in pain to a bee sting. At the site of the lesion, there is a slight swelling, and pain occurs. There is also a feeling of heaviness throughout the body, excessive sleepiness, apathy, lethargy. As a rule, after a few days, all these signs disappear on their own.

Brown recluse spider bite

At first, a slight burning sensation is felt at the site of the bite.After about eight hours, the affected area begins to turn red and cause a lot of pain. A fluid-filled blister then appears. Over time, this blister disappears, but an ulcer remains in its place, which tends to grow in size all the time. The patient complains of pain throughout the body, anxiety, and high body temperature. Very rarely, the bite of this spider can be fatal. As a rule, such cases were observed only among children.

A bite of a karakurt

In its soreness, a bite of a karakurt is like a light prick. The first signs appear only after sixty to one hundred and twenty minutes. At first, the victim develops redness, pain at the site of the lesion, as well as a slight swelling. Then, very severe pains make themselves felt not only in the area of ​​the bite, but also in the calf muscles, shoulder blades, abdomen, and in the lumbar region. The patient has weakness, dizziness, nausea. In severe cases, symptoms occur at an extraordinary rate and can lead to cardiac arrest.In about two percent of cases, the death of the victim is noted.

What if a wasp stung in the face – cheek, lip, eye, nose, tongue?

These insects usually sting in the arms and legs. However, they can also bite in the face: cheek, lip, eyes, nose, tongue, mucous membranes of the oral cavity. It is very dangerous. If an insect flew into its mouth, frightened by unusual conditions, it will sting again and again until it uses up all the reserves of the poisonous secret. If there is nothing wrong with moderate swelling of the tongue and lips, except for unpleasant sensations and problems with swallowing, then swelling of the larynx and nose can lead to suffocation.

Damage to the eye is fraught with inflammation of the eye and mucous membranes. Bites on the face and neck are considered the most dangerous. If measures are taken untimely or incorrectly, the victim may die. To prevent this from happening, a person bitten by a wasp in the face must be immediately taken to the nearest medical facility.

First aid for a spider bite

Author: Pashkov M.K. Content project coordinator.

Domestic spider bite is a phenomenon that affects more than 10,000 people every year.Although spider bites are fatal in some cases, depending on the geographic distribution of arthropods, they are generally benign and harmless.

There are three types of lesions:

1. Local. The reaction takes place at the site of the bite.
2. System. Reactions affect several systems or organs of a person due to the specificity of the action of the spider venom.
3. Allergic. They are observed in people with individual allergic reactions to the bite of a domestic spider.

Local reactions usually develop on the skin and do not pose a fatal threat to humans, and the latter two can affect human health and lead to death.

Identification

• Tarantulas – the largest venomous spiders in the world . The size varies from 2 to 10 cm in length with a leg span of up to 30 centimeters.
• They have a long life. Females live up to 30 years, males no more than 10, their life expectancy is often less than a year.
• Tarantulas have dark brown bodies and legs, with reddish hairs on the back.

Some dangerous spiders are associated with tarantulas and are often confused with them. A popular urban legend claims that deadly tarantula species exist somewhere in South America.

This statement is often made without identifying a specific spider, sometimes referred to as the “banana tarantula.” A likely candidate is the dangerous Brazilian wandering spider Phoneutria fera from the family Ctenidae.Watch the video spider in bananas

Sometimes it hides in bunches of bananas and is called the “banana spider”. Technically, this is not a tarantula, but rather large (10 – 12 centimeters), a little hairy and very poisonous to humans. Another dangerous type of poisonous spider that is confused with tarantulas is the Australian funnel.

The most famous of Sydney’s Atrax robustus, an aggressive one that (until the development of antivenom in the 1980s) was the cause of numerous deaths.

Is a member of the same suborder as the tarantulas, Opisthothelae.Australians use the slang term “triantelope” for the large, hairy and harmless members of the hunting spider family, which are often found on the interior walls of houses and cars.

Who are spiders?

Spider is an arthropod insect belonging to the class of arachnids. Modern science has more than 40,000 varieties. Almost all are predators and feed on a variety of fauna (from midges to small birds).

The territory, which previously included all the countries of the USSR, is inhabited by more than 3000 species of arthropods.How to tell which spiders bite and which don’t?

Spiders weave webs to catch their prey. Some types of spider webs are used to make silk. When food gets trapped, the arthropod hunter releases poison into the body. Almost all species are poisonous, but differ in the strength and nature of the poisonous substance, as well as the power of the bite. Small individuals cannot bite through human skin and are included in the “non-hazardous” group, while others easily let poisonous substances into the body. How a spider bites depends on the species and size of the insect.Almost all patients report sharp pain like a pin prick.

Scientists divide spider toxins into two types:

Habits

Some tarantulas hunt in trees, others on or near the ground. Everyone can produce silk. Arboreal species live in a silk “tubular tent”, ground ones line their burrows with silk to stabilize its wall and facilitate climbing up and down.

Tarantulas eat large insects and other arthropods such as centipedes and other spiders, using ambush as their main hunting method.

Armed with powerful chelicerae with long chitinous canines, tarantulas are well adapted to kill large arthropods. The largest ones sometimes kill and consume small vertebrates such as lizards, mice, bats, birds, small snakes.

Birds, snakes, hawks, foxes, some desert animals, other tarantulas hunt this spider.

Tarantulas are nocturnal, that is, they are most active at night. They usually do not wander far from their burrows.

However, during the mating season, males travel far from their nests to find females.The male “knocks on the door” of the female’s burrow (tapping on the cobweb). The female can ignore him, go out, or simply eat the caregiver if she is hungry.

They are shy creatures, but appear aggressive when they feel threatened. They rise on their hind legs and expose their fangs, ready to attack.

Reaction of the body to a spider bite

Local reactions are expressed by external symptoms. After the bite, the typical lesion is characterized by canine marks (leaving 1–2 separate entrances). Local inflammation occurs within minutes, resulting in a bright red spot followed by induration.Sometimes this can be accompanied by the formation of new red plaques around. Localized swelling usually lasts 7-10 days.

In some cases, a more serious reaction, called necrotizing local reactions, can occur from the bite of certain species. In such cases, a bubble occurs, followed by the formation of an ulcer with a crater. The wound heals over several weeks with the formation of a scar.

Systemic reactions – internal inflammatory processes. Sometimes, during bites, the components of the venom can be introduced into the body in sufficient quantities to damage several systems.When this happens, most of the venom passes through the circulating lymph. Thus, non-specific generalized systemic inflammation may occur, leading to symptoms such as:

• fever;
• muscle pain;
• fatigue;
• enlarged units.

Some species of arthropod predators cause blood clotting disorders.

Other systemic effects are common with species-specific venoms, for example: the bite of a brown recluse spider (Loxosceles reclusa) can cause a serious red blood cell disorder.The notorious black widow spider (Latrodectus sp) can cause a syndrome characterized by severe muscle cramps, nausea and vomiting, and is rarely fatal.

In addition to specific syndromes, the most dangerous is an allergic reaction, either due to a direct bite or contact with spider hair. This happens in tarantulas. Symptoms can range from mild to anaphylactic reactions. The latter can be life threatening and is considered a reason for calling emergency medical attention.

What do spider bites look like?

Spider bites are different and have their own specific appearance. What to do if bitten by a spider at home, on the street or in the forest:

1. Determine the type of individual.
2. Treat the bite site.
3. Go to the hospital.

Each arthropod has its own characteristic bite. What a spider bite looks like in reality, we will consider further.

Cross

The bite of a cross spider is almost harmless, except for the feeling of discomfort in the affected area.The poison used by the predator has a low concentration and is not able to paralyze or kill a person. A spider bite outwardly looks like a white spot, edged with a red ring.

The first symptoms are:

• burning at the site of injury;
• joint aches;
• slight dizziness.

The human body removes toxic substances in 24-48 hours, after which the symptoms disappear, a slight swelling remains at the site of the bite.

Tarantula

A tarantula bite is dangerous only for people with allergies. They have:

• intense fever;
• local edema;
• severe pain;
• numbness;
• rash.

When a spider bites, a small wound with a diameter of 2-3 mm appears. A tubercle appears due to the accumulation of poison under the skin. Typical for other species, wound bleeding and crusting are not observed.

Hermit

If a hermit spider has bitten – the first 5-6 hours the symptoms practically do not bother, then there are:

• severe pain at the site of the bite;
• headache;
• nausea.

Hermit’s venom is very dangerous because it causes tissue necrosis. The skin turns red and over time a blister appears, which bursts and characteristic ulcers are formed, developing into a gangrenous eschar.

Domestic spider

The bite of a domestic spider looks like two small red spots. This type is safe and does not cause serious consequences. If bitten by a home spider, apply a cold compress. In case of swelling and redness, take an antihistamine (according to the instructions).In most cases, symptoms of a spider bite go away after a few hours and do not require a doctor’s call or hospitalization.

Tarantula

The concentration of the poison is very low, so the bite of the tarantula does not cause serious harm to humans. The main task of the tarantula is to paralyze the victim. The lesion looks like two small bleeding spots with some redness around it.

Karakurt

The bite of a karakurt looks like two inflamed small tubercles against the background of a red spot 5-10 mm in diameter.The defeat of karakurt poison, without timely treatment, causes:

How is the bite processed?

What to do with a spider bite? Treatment is symptomatic. Below are the different treatment options based on the types of reactions.

Local Reactions

First Aid for a Spider Bite – cleaning the injury with soap and water, applying dry ice to reduce swelling, and observing the patient for a period of time for signs of systemic reactions.Immobilization of the bite site (for example, splinting the affected limb) slows down the lymphatic spread of the venom. Alternatively, a tetanus shot may be given. Necrotic lesions are treated with surgical removal of dead tissue, pain relievers, sterile dressing, and rest.

Systemic reactions

Includes the treatment of target organ damage:

• maintaining an adequate fluid state;
• blood transfusion for extensive breakdown of blood cells;
• pain relief;
• calcium gluconate injection to relieve intoxication.

Allergic reactions

Therapy, as in any other type I hypersensitivity reaction, includes:

• antihistamines;
• steroids;
• Epinephrine for life-threatening reactions such as angioedema and anaphylaxis.

Muscle Spasms

Treat with antivenom targeting specific spider bites. Side effects of this therapy include fever, joint pain, muscle pain, swollen lymph nodes, and skin rash.

By no means in all cases a spider bite poses a danger to human health and life. Possible consequences depend on the type of insect and the individual reactions of the victim’s body to the enzymes that the spider injects during the bite. To reduce the risk of developing severe consequences, it is necessary to know the main rules of first aid and the principles of treatment.

Why is a spider bite dangerous?

If bitten by a spider that is not poisonous to humans, in most cases this does not have an adverse effect on the victim.However, for some people, this can be fatal. Even the bite of a non-venomous spider can provoke a local allergic reaction. People prone to allergic reactions may develop anaphylactic shock, Quincke’s edema and death within a few hours as a result of upper respiratory tract edema.

The damage to the victim from a bite of a poisonous spider can be no less pronounced. The consequences depend on the characteristics and amount of the substance injected by one or another type of insect.The greatest danger is posed by the bites of large individuals, since the amount of poison they produce is often enough to harm a child or adult. However, there are also exceptions.

All types of enzymes that secrete poisonous glands with which the spider stings the victim, depending on the nature of the effect on the human body, can be divided into 2 large categories. The first includes those that have a neurotoxic effect, affecting the peripheral and central nervous systems. The second includes poisons that have a hemolytic effect.In this case, the rapid spread of the poison through the circulatory system causes the destruction of red blood cells.

General

Tarantulas are a group of large and hairy venomous spiders belonging to the Theraphosidae family. Found about 1000 species. Many other members of the same suborder (Mygalomorphae) are commonly referred to as “false tarantulas.”

Some of the more common species have become popular exotic pets. The New Worlds kept as pets have shrinking hairs that irritate the skin and damage the eyes.

Like all arthropods, the tarantula is an invertebrate. Relies on exoskeleton for muscle support. The body consists of two main parts:

1. Prosoma (cephalothorax).
2. Opistosoma (abdominal cavity).

Prosoma and opisthosoma are connected by a pedicle or pregenital somite. This waist-like connector is actually part of the prosoma and gives the opisthosoma a wide range of motion.

Clinical signs of bites of different individuals

The enzyme composition of the poison, which is produced in the domestic tarantula spider, cannot cause significant harm to humans.In this case, swelling and redness are possible only in the area of ​​the bite. Karakurt (black widow) is a relatively small spider, but its bite can cause pain, a general deterioration in the condition and a local allergic reaction. Signs of severe intoxication of the body can persist for several days.

A tarantula bite causes intense pain, numbness of the limbs and heart rhythm disturbances. The venom of this spider often causes severe allergic reactions.For children and people with a weakened body, the bite of this arthropod can be fatal.

The cross is relatively common in Russia and the CIS countries. Spiders often coexist with people, twisting a large cobweb even in apartment buildings, but they attack only on rare occasions. The cross can only bite if the person is dangerous. The poison of the cross is hemolytic and leads to a violation of oxygen delivery to all tissues of the human body. This causes a worsening of the condition.Adverse effects can persist throughout the day and then subside. Even large individuals of this species of spider cannot produce enough venom to be fatal.

Etymology

Arthropod, originally called “tarantula” – Lycosa tarantula, a species of wolf spider that lives in Mediterranean Europe. The name comes from the southern Italian city of Taranto.

The term “tarantula” was subsequently applied to almost all large, unfamiliar species of terrestrial spiders.For example, migalomorphs, especially Theraphosidae. Compared to tarantulas, wolf spiders are not particularly large or hairy.

When North and South American physicians treated bites, spiders were called “tarantulas,” which led to the use of the term for all tropical species.

The name is incorrectly applied to other large-bodied spiders, including spiderweb or atypical tarantulas, funnels (Dipluridae, Hexathelidae) and “dwarf tarantulas”.

They are all migalomorphs, but are classified in different families.Hunting spiders of the family Sparassidae are also called “tarantulas” because of their large size. In fact, they are not related, they belong to the Araneomorphae.

Learn more Why a chinchilla bites fingers

Signs

When a poisonous spider bites, the symptoms of the lesion increase rapidly.

Often the bite is not felt, but it can also resemble a needle prick. In most cases, after 10-15 minutes, the first manifestations appear in the form of a white or red spot on the skin.After 1–2 hours, pronounced symptoms of an arthropod attack appear. The severity of manifestations depends on the type of spider and the type of venom. The following signs may indicate a bite of a poisonous arthropod:

• red spots on the skin;
• aches and pains in muscles;
• facial flushing;
• convulsions;
• blisters and wounds at the site of the bite;
• foci of erosion and necrosis;
• soft tissue edema;
• urticaria;
• excessive sweating;
• severe headache;
• itching and burning;
• numbness and tingling of the extremities;
• heart palpitations;
• abdominal pain;
• muscle spasms;
• attacks of suffocation;
• shortness of breath.

With a critical lesion of the central nervous system, a person begins to lose consciousness. Strong salivation is observed, and respiratory arrest is possible. In severe cases, the patient falls into a coma. The condition is aggravated due to the increasing intoxication of the body, which can be expressed by the following symptoms:

• increase in body temperature;
• vomiting;
• nausea;
• diarrhea;
• general weakness;
• chills;
• cyanosis of the skin.

In some cases, during the day, the patient’s condition deteriorates so much that the existing disorders begin to pose a danger to life.

What ointments to use?

Products for external use help to cope with severe itching and accelerate the healing process. Proper use will reduce swelling. It is allowed to use ointments and gels:

• Fenistil. Dimethindene maleate is present in the gel. Apply to inflammation up to 4 times a day.It is not allowed to use in children under the age of 1 month, in the presence of glaucoma and prostate adenoma;

• Sinaflan. Hormonal ointment, quickly relieves discomfort. Apply up to 4 times a day, you cannot use it for a long time. It is not used in babies under 2 years old, during pregnancy and breastfeeding, with some diseases of the skin;

• Advantan. A good drug containing hormones and the presence of contraindications.It is permissible to smear several times a day, but not for a long time. Not used for viral diseases, skin lesions with tuberculosis and syphilis;

• Psylo-balm. An antihistamine that quickly relieves unpleasant symptoms – edema, fever in the affected area, itching. It has a mild analgesic effect.

It is possible to use conventional insect bites, even a simple Moskitol will help. However, relief will come later than from medication.

First aid for bites

In case of poisonous spider bites, it is necessary to provide first aid to the person as soon as possible. The affected area should be washed with soap under running cold water. To prevent damage to the skin and tissue, you need to immobilize the limb. The bite site can be treated with the following antiseptic agents:

To reduce the risk of spreading toxins, it is recommended to tighten the limb with an elastic bandage above the damaged area.

Apply a cold compress to the bite site. After providing first aid, you should call an ambulance.

What not to do

Often people, when bitten by a tarantula, take the wrong action, thinking that they will help. However, in most cases, this only exacerbates the situation. Experts do not recommend:

• Cauterize the bite site. In theory, high temperatures can neutralize the poison. As practice shows, this method is ineffective, in the end it is also necessary to treat the burn.
• Cut open the wound with a knife. This action is taken to quickly suck out the poison. However, there is a great risk of infection. In addition, toxins are quickly absorbed into the deep layers and blood, which is why such actions do not bring the desired result.
• Brush the affected area as a bacterial infection can occur.
• Apply harness. A sharp violation of blood circulation increases the degree of tissue damage and intoxication.
• Drink alcohol.Alcohol accelerates the spread of toxins throughout the body.

If a tarantula has bitten a child or a person with a weakened immune system, you cannot refuse medical care and self-medicate, as this can lead to serious consequences.

Treatment

After a bite, you must seek qualified medical help, since severe intoxication is associated with a high risk of death. If there is a suspicion of a poisonous arthropod bite, the patient is admitted to the hospital for observation and treatment.

If a spider species is identified, an antidote may be given. Complex detoxification therapy is carried out to stabilize the condition and remove toxins. Antihistamines are prescribed to reduce allergic reactions. Such means are often used:

1. Suprastin.
2. Zodak.
3. Tavegil.
4. Claritin.
5. Diphenhydramine.
6. Cetrin.
7. Loratadine.

Drugs are prescribed to eliminate the existing symptomatic manifestations.With severe headaches and muscle pain and inflammation, antispasmodics, analgesics and non-steroidal anti-inflammatory drugs are prescribed. Frequently used drugs:

With a sharp increase in blood pressure, antihypertensive drugs are prescribed. At the beginning of the necrotic process, surgical intervention is required to cleanse the existing wound.

Prevention of attacks

Bees are peaceful insects, so bites can be avoided.It is recommended to follow simple rules:

• do not wave your hands, do not make sudden movements if the bee is nearby;
• Be careful when eating sweet food outside;
• when going on a hike, give up too bright and revealing clothes;
• do not climb into the hive on your own;
• do not use too intense perfumery and cosmetics in nature;
• Carbonated drinks are best drunk from closed glasses.

If a bite has occurred, then first aid is provided as soon as possible in order to avoid further negative consequences.

Getting rid of swelling after a bee sting is not difficult. Timely measures taken help to reduce negative symptoms and quick recovery. For medicinal purposes, medications and folk recipes are used.

Consequences and complications

Spider bites are fraught with extremely serious consequences. Children and the elderly with weakened immunity may develop the following complications:

• residual neurological disorders;
• paralysis;
• disorders of urination and defecation;
• gangrene;
• chronic pain;
• heart and renal failure;
• hemolysis;
• cerebral edema;
• Loxocellism.

Increasing intoxication can cause multiple organ failure. Violations increase the risk of death.

Preventive measures

Contact with poisonous spiders should be avoided to avoid bites. It is necessary to teach children not to take arthropods in their hands. The home should be regularly cleaned in the living area to avoid the entry of dangerous insects.

When staying in the forest, field and in other places where it is possible to meet poisonous insects, you need to use special protective equipment, incl.including insect repellent sprays and closed clothing. If you plan to spend the night in nature, you need to stock up on canopies.

Habitat

Tarantulas of various species are found throughout the United States, Mexico, Central and South America. Others are found in Africa, most of Asia (including the Ryukyu Islands in southern Japan), and throughout Australia. In Europe, some species live in Spain, Portugal, Turkey, southern Italy, Cyprus.

Live in underground burrows, going out at night to hunt or in summer and autumn to mate.They are found in homes, but most often because they are kept as pets.

Watch the video – Tarantulas settled in the Gomel region

A specialist from the Ministry of Health told how to protect yourself from a snakebite – Haqqin

In Azerbaijan, as in the rest of the world, snakes, poisonous spiders and scorpions are activated in the summer season. As a result, in connection with the bites of terrestrial poisonous animals in the summer months, the number of visits by the population to poison control centers is increasing. For what types of poisoning do citizens most often turn to toxicologists? What is the difference between bite symptoms? Ismail Efendiyev, associate professor of the Department of Internal Diseases of the Azerbaijan Medical University, Doctor of Philosophy in Medicine, clarifies these and other issues.

– What does the concept of toxicology include, and what is the essence of the profession of a toxicologist? What complaints do citizens make to toxicologists?

– Toxicology is a unique field of knowledge in Azerbaijan, the history of development of which in our country dates back to 1982. Prior to this, a very high mortality rate was observed in acute chemical poisoning. So, in 1982, the death rate from poisoning was approaching 10 percent. After the creation of the toxicological service, the mortality rate from intoxication dropped to 1.8 percent.Toxicology is currently one of the hottest areas studied by the World Health Organization (WHO). The number of pesticides in the world is growing every year. Every year, more than 2.5 million people worldwide are poisoned by snakebites alone, and tens of millions are poisoned by carbon monoxide, various drugs, new drugs sold on the black market and other chemicals used in industry. In addition, with the development of agriculture, pesticide poisoning is also increasing every year.According to WHO forecasts, as the chemical industry develops, the demand for toxicological services in this area will increase. Even in times of war, such chemicals are used as weapons.

– What types of poisoning do you most often refer to?

– During the year, poisoning with acetic acid, drugs, drugs and alcohol occurs, one might say, in almost the same proportions. Other types of poisoning in toxicology are seasonal.For example, in summer, bites of poisonous animals are more common, poisoning by poisonous mushrooms in autumn, in winter – carbon monoxide poisoning. More than 100 cases of intoxication from snake bites occur in Azerbaijan every year. According to the requests, the largest number of poisonings occurs from the beginning of April to November.

– Such a question: let’s imagine that, while working in a garden plot, we did not see which poisonous animal stung us. What symptoms should be of concern to us, and how are they different?

– First of all, you should look at the site of the bite.If a snake bites, then at the site of the lesion, two scarlet dots are usually noticeable – tooth marks. You should immediately consult a doctor, because in this case you cannot waste a minute. Since poisonous spiders are small, many do not immediately feel their bites. After some time, severe pains, muscle spasms, tremors appear in the human body. The risk of serious intoxication from the venom of scorpions in our country is relatively low. A painful swelling appears at the site of the bite.

– Doctor, what should be the first aid algorithm in such cases?

– This is a very important question and, one might say, the most problematic part in our profession.Regardless of how well we understand this issue, misconceptions that we do not consider as such further exacerbate these situations. All deaths, complications and blood clots occur in people who, after being bitten by a snake, try to close the affected area by squeezing out or sucking out the poison. These are the wrong methods.

– Sometimes in this way we contribute to the further spread of the infection. What to do in such situations?

– First, you should remain calm and not panic.No later than 12 hours after the snake bite, you must consult a doctor, according to the recommendation and prescription of which the serum should be injected. I emphasize once again: this serum should be administered only under the supervision and as directed by a physician. Since serum is an immunological drug derived from the horse’s blood plasma, many people may develop an allergic anaphylactic reaction. What to do in such situations? Secondly, try to move less, otherwise the poison will spread very quickly throughout the body.You should be aware that at the initial stage, snake venom spreads throughout the body through the lymphatic system, and not through the blood. Therefore, blood vessels must not be squeezed. It is necessary to apply a cold, non-pressure bandage to the affected area, and then consult a doctor. Pain relievers and antihistamines can be taken at home.

If you have been bitten by a spider, it is likely that it is venomous. In the first 2 minutes after a spider bite, you need to burn this place with matches – attach two matches to the wound, and set the third on fire for a few seconds.In this way, you can prevent the spread of the poison by thermocoagulation.

– Can there be a long-term effect on the body and complications after the bites of poisonous animals?

– Yes, unfortunately, we have been observing complications after snake bites for a long time. One of the main reasons for this is that the poison spreads through the lymphatic pathway, damaging the lymphatic vessels of the body and causing swelling in this area. Sometimes this situation lasts for years.Squeezing this area slows down healing. What can happen? Swelling of the foot, various problems with blood vessels, thrombosis can even lead to amputation. I emphasize once again: in such cases, it is necessary to see a doctor in time.

– Thank you for an interesting and informative interview.

First aid for stings of bees, wasps, spiders and scorpions | Health

Most insect bites, which lead to the development of a reaction in small animals, are caused by representatives of the Hymenoptera family ( bees, hornets, wasps ).Most often insects sting curious

animals in the face and limbs, where the thinnest skin. The peak of activity of bees and wasps is observed at the beginning and end of the summer period.

With single bites, as a rule, no serious consequences are observed if the animal is not allergic to hymenoptera venom. Exposure to large amounts of venom from multiple bites can cause life-threatening and often fatal multiple organ damage.

The venom of these insects contains vasoactive substances and peptides (histamine, hyaluronidase, phospholipase), which provoke allergic and toxic reactions. Local toxic and allergic reactions are characterized by swelling, redness and pain at the site of the bite and are usually self-limiting. Bites in the area of ​​the tongue and larynx are fraught with swelling of the respiratory tract up to suffocation, therefore, require the use of emergency measures.

In the presence of hypersensitivity, anaphylaxis with edema of the head and larynx region, up to Quincke’s edema, can quickly form in an animal – an increase in edema and respiratory disorders also require urgent intensive therapy.

Generalized allergic reactions can also manifest as urticaria, mainly in the area

abdomen and groin.

Generalized toxic reaction is accompanied by general depression, weakness, hypotension (blanching of the mucous membranes) up to shock, or, conversely, hyperemia (redness) of the mucous membranes, fever.With the development of secondary complications in the lungs, shortness of breath (respiratory distress) may increase. Neurological signs manifest as paresis of the facial nerve and paralysis or seizures. Coagulopathy due to the toxic effects of poison leads to the appearance of blood in the feces and urine, petechiae (hemorrhages) on the skin and bleeding at the site of venipuncture.

In uncomplicated cases, treatment consists of removing the sting and applying cold or soda compresses.

In severe cases, glucocorticoids (dexamethasone, prednisolone) may be needed, preferably injections.The use of antihistamines (suprastin, claritin, kestin, cetrin, etc.) can also be beneficial, but has much less effect. With respiratory distress, oxygen inhalation is required. Systemic disorders require active fluid therapy and symptomatic treatment according to the situation.

First aid for a bee or wasp sting:

1. If the cat is bitten in the mouth, nose or throat, go to the veterinarian immediately, because the swelling can block the airway.

2. If the cat is bitten by a bee, the sting may still be in the skin. If you see it, gently grasp it with tweezers as close to your skin as possible and remove it.

3. Try to neutralize the bite by rinsing the affected area with a solution of baking soda (10 g (1 dessert spoon) of salt in 600 ml of water). With an aspen bite, the affected area should be washed with a vinegar solution (vinegar, half diluted with water). If these measures do not help, then try washing the bite sites with soap and water to relieve the pain of the bite.

4. Apply a cold compress to the bite from a piece of cloth dipped in ice water (if possible, wrap ice cubes in the cloth) or a bag of ice cream peas. These measures will help relieve swelling.

Spider bites. Black Widow and Brown Hermit Spider are the only spiders that cause severe poisoning in dogs and cats.

Black widow bite poisoning occurs only when bitten by females, males have shorter poisonous teeth that do not pass through the skin. Poisoning symptoms are severe and often fatal in small animals. A local inflammatory response is indicated by a pale central area surrounded by erythema (redness). In animals, salivation, vocalization (screaming) and severe soreness of the abdominal wall and hind limbs with increased muscle tone, as well as damage to the respiratory muscles and shortness of breath are often recorded.Treatment includes administration of antivenom, corticosteroids, calcium gluconate, and fluid resuscitation. Improvement after fractional administration of the antidote is noticeable after 1-2 hours.

A hermit spider bite is characterized by a bull’s eye lesion with a black center within a white ischemic area surrounded by a ring of erythema. Lesions on the side can descend in the form of “tears”. Such bites rarely cause systemic toxic reactions, usually accompanied by local inflammation and tissue necrotization at the site of the bite.Treatment consists in surgical treatment of the wound and the use of broad-spectrum antibiotics, glucocorticoids, and wound oxygenation.

First aid for spider and scorpion bites:

1. Limit your cat’s mobility. Movement will only accelerate the spread of the poison throughout the body.

2. Thoroughly rinse the site of the bite with plenty of running cool water to get rid of the venom on the surface of the skin.

3. Do not cut the wound, do not try to suck out the poison.

4. If a paw is bitten, keep it below the level of the heart, apply cold to it and bandage it, wrap it tightly with a thick layer of cotton wool, and put a tight elastic bandage on top. Tourniquets are not as effective at slowing the spread of poison as bandages.

5. Be sure to contact the nearest veterinary clinic.

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07/27/2017 Everyone needs to know this!

Camping outside the city often turns into a tragedy due to the bites of various stinging insects. The most dangerous in terms of the development of anaphylactic shock and Quincke’s edema are stings of a bee, wasp, hornet, bumblebee and tarantula. All these insects have a strong damaging effect due to the production of poison located directly in the sting. The bite of a taiga tick is no less dangerous in terms of the development of severe infectious diseases – borreliosis, tick-borne encephalitis and Lyme disease.

First aid for all cases of insect bites

Regardless of which insect bite you received, doctors recommend applying a cotton swab moistened with calendula tincture to the wound – it will not only relieve inflammation, but also serve as an antiseptic due to the alcohol it contains. In any case, if you are going to nature, you need to have a gel or ointment with an antiseptic, anti-inflammatory and wound healing effect on hand (for example, fenistil-gel, homeopathic cicaderm ointment).If, after a bite, you have shortness of breath, headache, nausea and vomiting, you should immediately consult a doctor!

If you have been bitten by a bee, wasp, hornet, ant.

Insects of this species sting for self-defense. With a bite, a poison, consisting of proteins and other components that are classified as strong allergens, enters the human body. Therefore, the skin responds to the introduction of these substances with redness, pain and swelling. Moreover, the reaction to the ingress of the poisons of these insects into the body is very fast (20 minutes or less).Immediately after the bite, it is necessary to carefully, slowly, pull out the sting if it remains in the wound. Then, for disinfection, apply a cotton swab moistened with calendula tincture, hydrogen peroxide or an alcohol-containing liquid. Apply ice to the site of the bite to relieve swelling and prevent its development. You can also use a piece of raw, halved potato (or tomato), or place chopped parsley leaves over the affected area to help relieve pain and swelling. To prevent an allergic reaction, it is best to take an antihistamine (loratadine, suprastin, diazolin, tavegil).

First aid for spider bite

If bitten by a spider:

Thoroughly wash the bite site with soap and water

Immobilize the affected part of the limb, fixing it with a board, a branch (tying them to the leg or arm). Movement will only accelerate the spread of the poison throughout the body.

If the bite site is on an arm or leg, apply a tight bandage above the bite site to prevent or slow the spread of the venom.Make sure that the bandage is not tight enough to cut off circulation to the limb.

Apply a cold compress to the bite site. You can use an ice pack or a bottle of cold water.

In order to eliminate the poison in the urine, it is recommended to drink plenty of fluids.

For mild symptoms, an adult can be given aspirin or acetaminophen. Do not give aspirin to children. It is better to give the child paracetamol.

Seek urgent medical attention if:

A child was bitten by a spider

The condition of the victim of a spider bite deteriorates sharply

3.If you suspect a bite of a “black widow” and a brown hermit, in the treatment of which it is necessary to introduce antivenom.

First aid for a bite of fleas, lice, scabies mites

Lesions caused by bites of fleas, lice and itch mites are so similar that their diagnosis is often difficult. Flea bites usually have a zigzag pattern, especially on the lower leg and lower back. Lesions appear as red dots surrounded by eruptions and swelling. The itching is intense, and often dull red spots remain even after the lesions have resolved.In children, bites can be complicated by the development of impetigo. Treatment is aimed at preventing secondary infection. The bite sites are thoroughly washed with soap and water. In children, nails are cut short to prevent scratching. Starch baths (about 1 kg of starch per bath), topical application of calamine, cold wraps, and antihistamines such as trimeprazine can help reduce discomfort and itching. With significant discomfort, topical application of steroids in the form of ointments or aerosols is indicated.If a secondary infection develops, topical antibiotics, such as neomycin or polymyxin, may be required.

First aid for tick bites

The danger of ticks lies in the fact that these blood-sucking insects are carriers of many infections, both bacterial and viral, among which the most dangerous are hemorrhagic fevers, encephalitis and borreliosis. The traditional habitat of ticks is woodland, the greatest activity is observed in the warm season, from about mid-spring to mid-summer.During this period, you need to be especially careful when visiting the forest – it is best to wear closed clothes. If, nevertheless, trouble did occur, you should know how to properly provide first aid in order to minimize the possible danger. It should be remembered that severe infectious diseases transmitted by ticks appear some time after the bite, and this time can vary significantly – from several days to several weeks. The first thing to do is to remove the tick.This should be done very carefully, trying not to crush the insect, since in this case the risk of infection increases many times over. To remove the tick, you can use medical tweezers, a special device sold in pharmacies, or a loop made from thread yourself. Try to grab the insect closer to the head, remove it slowly, pull it perpendicular to the skin, while making swinging or slightly rotating (unscrewing) movements. The removed tick must be placed in a small glass container with water, equipped with a tight-fitting lid.After the insect has been completely removed, the wound is washed with soap and water, then treated with an antiseptic. If the proboscis of the tick breaks off and remains in the skin, it should not be picked out, after a while – it usually takes several days – it will come out on its own. The bite site is treated in the same way. At the first signs of an allergic reaction, as a first aid measure, it is necessary to give the victim an antihistamine (loratadine, suprastin, diazolin, tavegil, etc.). First aid provided, what to do next? If the region in which such a case occurred is classified as unfavorable in terms of the epidemiological situation in relation to ticks, for example, there are known cases of the development of tick-borne encephalitis or other infectious diseases carried by them, then immediately after providing first aid, it is necessary to take the extracted insect to the laboratory for analysis ( or consult an infectious disease doctor at the place of the attached territory).

First aid for snakebite

So, everything has already happened – a man was bitten by a poisonous snake. What to do in this case, how to help the victim and prevent the development of severe complications?

Firstly, it is necessary to put the bitten person in a horizontal position and try to calm him down – anxiety, tantrums and panic will definitely not help. If the snake is fixed on the skin at the site of the bite (this, by the way, happens often), it must be removed and destroyed, but not thrown away anywhere – the reptile may be needed for examination by a specialist.

Secondly, if possible, you need to immediately call an ambulance, contact rescuers or a recreation center, a hotel. While you are doing all these actions, carefully observe the victim – the absence of burning, swelling and pain at the site of the bite, most likely, indicates the non-toxicity of the snake.

Thirdly, the affected part should be freed from clothing and jewelry – they can put pressure on the bite site and provoke increased edema.

Please note: if the symptoms indicate that the person was bitten by a poisonous snake, then medical assistance should be provided immediately, without waiting for the arrival of the ambulance team!

Snake venom poisoning involves the introduction of specific serums (antidotes) – it is advisable to do this on the first day after the bite.In the future, if necessary, you can enter another dose of serum.

ATTENTION!

In the event of a bite from wool, ticks or other insects, the victim can consult an infectious disease doctor, a surgeon at the place of residence or the trauma center of the TGBUZ “City Clinical Hospital named after Archbishop Luke of Tambov “

In case of a poisonous snake bite – directly to the emergency room of the TOGBUZ “City Clinical Hospital named after Archbishop Luka of Tambov “, admission department of the Tambov Regional Clinical Hospital named afterV.D. Babenko “.

isp .: head. 1 ter dep. – Meshcheryakova Lyudmila Vyacheslavovna

Animal bites

Animal bites represent a significant public health problem for children and adults around the world. The health consequences of animal bites depend on the species and health status of the animal, the size and health of the affected person, and the availability of appropriate medical care.

Many species of animals have the potential to bite humans; however, bites from snakes, dogs, cats and monkeys are the most problematic.

Snakebites

Magnitude of the problem

Up to five million people worldwide are bitten by snakes every year. Among this number of people, venomous snakes cause significant morbidity and mortality. An estimated 2.4 million cases of intoxication (poisoning from snakebites) and 94,000-125,000 deaths occur annually, as well as 400,000 cases of amputations and other severe health consequences such as infection, tetanus, scarring, contractures and psychological consequences.Poor access to health care and a lack of antitoxins increase the severity of injuries and their outcomes.

Who is most at risk?

Most snakebites occur in Africa and Southeast Asia. Snakebites are most common among people living in rural areas with limited resources, low-wage, non-mechanized field crops and other types of agriculture. Agricultural workers, women and children are the populations most frequently affected by snake bites.The burden of these injuries is compounded by their socioeconomic impact on families and communities. Adult victims are often the breadwinners and caregivers for other family members; and child victims can suffer lifelong disabilities, which imposes additional costs on families and communities.

Treatment

There are approximately 600 species of poisonous snakes in the world, and approximately 50-70% of their bites lead to intoxication. Immediately after the bite, it is extremely important to ensure the complete immobilization of the affected part of the body and the immediate delivery of the victim to a medical facility.Applying tourniquets and cutting out the bite should not be used as first aid, as this can exacerbate the effects of the venom. Often, snakebite victims require antitoxin treatment. It is important that an appropriate antitoxin is used, taking into account the snakes that are endemic in the area. Additional measures include cleaning the wound to reduce the risk of infection, supportive therapy such as breathing support, and tetanus vaccine at discharge if the patient is not adequately vaccinated against tetanus.

Snake Bite Prevention

In order to prevent snake bites, local communities should be educated about the risks of snake bites and how to prevent them, such as:

• avoid areas with tall grass;
• Wear safety shoes / boots;
• keep rodents away from food storage areas;
• to free the area adjacent to the house from garbage, firewood and low vegetation;
• In homes, store food in containers that reliably protect them from rodents, arrange sleeping places on a raised level above the floor and carefully tuck mosquito nets under the mattresses.

To prevent or limit the serious health effects of snakebites, healthcare providers should have specific training in snakebite management, including the proper use and administration of antitoxin. Public health authorities and policy-makers should ensure that adequate supplies of safe and effective antitoxins are available in the communities, countries and regions where they are most needed, and prioritize the research initiatives on which the burden of such injuries will depend.

Dog bites

Magnitude of the problem

There are no global estimates of the prevalence of dog bites, but research suggests that dog bites are responsible for tens of millions of annual injuries. For example, in the United States of America, about 4.5 million people are bitten by dogs every year. Of these, about 885,000 people seek medical help; 30,000 people are undergoing reconstructive surgery; 3-18% of people develop infections, and 10 to 20 cases are fatal.Other high-income countries such as Australia, Canada and France have similar prevalence and case fatality rates.

Data is more fragmented in low- and middle-income countries, but some studies show that dogs account for 76–94% of all animal bite injuries. Fatality rates from dog bites are higher in low- and middle-income countries, as many of these countries, where rabies is a problem, may lack the medicines needed for post-exposure treatment, along with inadequate access to health care.An estimated 59,000 people die from rabies every year, and most of these deaths are due to the bite of rabid dogs.

Who is most at risk?

The majority of people exposed to dog bites are children, mostly middle-aged and older. Children are at a higher risk of head and neck injuries than adults, and such injuries are particularly severe. They have higher rates of medical treatment and mortality rates.

In some countries, men are more likely to be bitten by dogs than women. Dog bites account for over 50% of animal-related injuries among travelers.

Treatment

Treatment depends on the site of the bite, the general health of the affected person, and whether the dog has been vaccinated against rabies. The basic principles of health care include the following:

• prompt medical treatment;
• washing and cleaning the wound;
• the application of primary sutures to the wound with a low risk of infection;
• prophylactic antibiotic therapy for high-risk wounds or people with immunodeficiency;
• post-exposure rabies treatment based on the dog’s vaccination status;
• Administration of tetanus vaccine in the absence of adequate vaccination in the affected person.

Preventing dog bites

Specific populations, especially children, should be educated about the risks of dog bites and how to prevent them by avoiding stray dogs and never leaving children unattended around any dogs.

Health care providers must receive specific training in the proper management of dog bites. Public health authorities and policy-makers should ensure control of rabies in dog populations, provide adequate supplies of rabies vaccines in the event of potential human exposure to rabies, and develop systems to collect information to further document the burden of the problem.

Cat bites

Magnitude of the problem

Globally, cat bites account for 2-50% of animal bite injuries. In terms of prevalence, they usually rank second after dog bites. In Italy, for example, the prevalence of cat-related injuries is 18 per 100,000, while in the United States of America, an estimated 400,000 cat bites occur annually and 66,000 associated visits to hospital departments. emergency medical care.

Who is most at risk?

The highest rates of cat bites are found in adult women.

Treatment

Treatment depends on the site of the bite and whether the animal has been vaccinated against rabies. The basic principles of health care include the following:

• prompt medical treatment, including wound cleansing;
• prophylactic antibiotic therapy to reduce the risk of infection;
• post-exposure rabies treatment based on the vaccination status of the animal;
• Administration of tetanus vaccine in the absence of adequate vaccination in the affected person.

Cat Bite Prevention

Individual communities need to be educated about the risks of cat bites and how to prevent them, including vaccinating cats against rabies.

Health care providers must receive specific training in the proper management of such injuries. Health authorities and policy-makers must ensure rabies control in animal populations and adequate drug supplies for post-exposure treatment and prophylactic antibiotic therapy in people affected by bites.They should also support research to provide more information on the burden of cat bites.

Monkey bites

Magnitude of the problem

Monkey bites account for 2–21% of animal bite injuries. In India, for example, two studies have shown that monkeys are the second most significant source of animal bite injuries after dogs.

Who is most at risk?

Monkey bites pose a significant risk to travelers and, after dog bites, are the second most important animal bites for travelers.

Treatment

Treatment depends on the patient’s health, the site of the bite, and whether rabies is suspected in the monkey. The basic principles of health care include the following:

• prompt medical treatment, including wound cleansing;
• prophylactic antibiotic therapy to reduce the risk of infection;
• post-exposure rabies treatment based on the vaccination status of the animal;
• Administration of tetanus vaccine in the absence of adequate vaccination in the affected person.

Monkey Bite Prevention

Individual communities and travelers should be educated about the risks of monkey bites and how to prevent them.

Health care providers must receive specific training in the proper management of such injuries. Health authorities and policy-makers must ensure rabies control in monkey populations and adequate drug supplies for post-exposure treatment and prophylactic antibiotic therapy in people affected by bites.They should also support research to gain more information on the burden of monkey bites.

WHO activities

WHO is taking action on a public health problem related to animal bites.

For snakebites, WHO has issued several methodologies to assist in the proper design, distribution and administration of antitoxins.

In relation to rabies, WHO is calling for increased access to post-exposure treatment by expanding the production of biologics against rabies, continued education on rabies prevention and control, and large-scale immunization in dog populations.

For animal bite injuries, WHO does the following:

• prioritizes data collection initiatives to help identify the burden and risk factors of such injuries;
• calls for the strengthening of emergency medical services for those injured;
• promotes research on effective interventions to prevent such injuries and the populations most vulnerable to such injuries.

The expert told how to escape from the bite of the karakurt spider using a match

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The expert told how to escape from the bite of the karakurt spider using a match

The expert told, How to escape from a bite of a karakurt spider with a match – RIA Novosti, 19.06.2019

The expert told how to escape from a bite of a karakurt spider using a match

High temperature quickly neutralizes the poison in the first seconds after a karakurt bite, therefore the best first help – extinguish a match about the bite site, told RIA Novosti, 19.06.2019

2019-06-19T14: 58

2019-06-19T14: 58

2019-06-19T14: 58

Society

Moscow Region (Moscow Region)

Moscow

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MOSCOW, June 19 – RIA Novosti. The high temperature quickly neutralizes the poison in the first seconds after a karakurt bite, so the best first aid is to extinguish a match about the bite site, Ilya Gomyranov, press secretary of the Zoological Museum of Moscow State University, told RIA Novosti.Recently, in the Moscow region, there were cases of the appearance of poisonous karakurt spiders, which had not been previously observed in the region. According to Gomyranov, the poison of karakurt begins to act immediately and can cause death. People have a burning pain after a few minutes, which after about 20 minutes spreads throughout the body. Usually, patients complain of unbearable pain in the abdomen, lower back, chest. Characterized by a sharp tension of the abdominal muscles. Symptoms of general poisoning include shortness of breath, increased heart rate, dizziness, headache, tremors, vomiting, sweating.Psychomotor agitation in the later stages of poisoning is replaced by deep depression, darkening of consciousness, delirium. “The spider’s venom contains mainly protein neurotoxins that are easily destroyed by high temperature. the temperature quickly neutralizes the poison, and the burn will soon heal.If in the first minutes the bite went unnoticed, the poison got into the bloodstream, and the person feels a deterioration in health, then you need to immediately go to the hospital, where the victim can be injected with a special serum, or they will be injected with novocaine , calcium chloride and other substances, “the expert advises.According to Gomyranov, 10-15% of people bitten by karakurt and who did not seek help die.

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MOSCOW, June 19 – RIA Novosti. High temperature quickly neutralizes the poison in the first seconds after a karakurt bite, so the best first aid is to extinguish a match about the bite site, Ilya Gomyranov, press secretary of the Zoological Museum of Moscow State University, told RIA Novosti.

Recently, in the Moscow region, there were cases of the appearance of poisonous karakurt spiders, which were not previously observed in the region.

21 January 2019, 12:00 Fear Fear of spiders Almost six percent of all inhabitants of the earth suffer from arachnophobia. In some, spiders cause acute hostility, irrational horror, which can manifest themselves physically: tachycardia or tremors (uncontrollable shudders).Others believe that spiders are more good than harm, see the beauty and aesthetics of autumn cobwebs, and keep poisonous individuals at home.

According to Gomyranov, the poison of karakurt begins to act immediately and can cause death. People have a burning pain after a few minutes, which after about 20 minutes spreads throughout the body. Usually, patients complain of unbearable pain in the abdomen, lower back, chest. Characterized by a sharp tension of the abdominal muscles. Symptoms of general poisoning include shortness of breath, increased heart rate, dizziness, headache, tremors, vomiting, sweating.