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22. Clenbuterol

Author

PRATHER, IRVINE D., primary, BROWN, DAVID E., additional, NORTH, PERRY, additional, and WILSON, JUDY R., additional

Published
1995
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27. Brown recluse spider bites: a complex problem wound. A brief review and case study.

Author

Wilson JR, Hagood CO Jr, and Prather ID

Subjects
Adult, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Antivenins therapeutic use, Combined Modality Therapy, Dapsone therapeutic use, Debridement, Diagnosis, Differential, Diphenhydramine therapeutic use, Enzyme-Linked Immunosorbent Assay, Female, Hemagglutination Tests, Histamine H1 Antagonists therapeutic use, Humans, Hyperbaric Oxygenation, Incidence, Necrosis, Seasons, Skin Care methods, Skin Transplantation, Spider Bites epidemiology, Spider Bites etiology, Spider Venoms adverse effects, Spider Venoms chemistry, Time Factors, United States epidemiology, Wound Healing, Spider Bites diagnosis, Spider Bites therapy
Abstract

Brown recluse spiders (Loxosceles reclusa) are responsible for virtually all documented cases of spider bites leading to significant necrosis. The actual spider bite often goes unnoticed for as long as 4 to 6 hours, which makes diagnosis and, therefore, appropriate treatment, difficult. The spider bite generally results in either a necrotic wound or systemic symptoms that can lead to hemolysis. The patient described in this article experienced both complications. Dapsone and hyperbaric oxygen therapy brought the adverse response to the bite under control. The patient was hospitalized for 7 days during treatment for hemolysis and an extensive, necrotic wound. Efforts are underway to develop an assay to provide a definitive diagnosis for the brown recluse spider bite, but none is yet commercially available. Antivenom is scarce; capture of the offending spider appears to be most helpful in the diagnosis and proper treatment of spider bites.

Published
2005

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