** The following information was compiled from various medical and collegiate sources. It is not intended to replace the advice or diagnosis of a medical professional. Some of the photos may be disturbing **

Identifying a Brown Recluse Spider Bite

If you see a mark on your skin that you think may resemble a spider bite, examine the bite very closely. If it is a spider bite, there will be two separate "fang marks" about 1/16th of an inch apart. If there is only one puncture present, the bite was more likely made by a mosquito, deer fly, bedbug or other insect. It may also be a sting or a thorn puncture. Brown Recluses are not known to be able to bite through t-shirts, pants, socks, pajamas or even through thick epidermal layers of skin such as the palm of the hand or bottom of the foot.  
 

Effects of the bite -

In a short period of time, the venom in a Brown Recluse spider bite has the ability to cause major tissue necrosis.  Necrosis is the death of living cells. The venom comes into contact with the living cells and they simply die. The result is a very painful and gruesome "flesh-rotting" open wound.  Fatalities are rare, but are most dangerous to children, the elderly and those in poor physical condition. The severity of the bite wound can vary greatly with some bites going unnoticed while others (though rare) reach the size of dinner plates. The amount of venom the spider injects can vary and tests indicate the spider is able to control the amount injected.

Source: NC State University

Brown Recluse spider bites can be difficult to diagnose, even by physicians. Diagnostic tests to detect Brown Recluse venom in tissue are not readily available. Collection of the spider that bit you is considered the best possible chance for positive identification. This presents a problem because Brown Recluse bites sometimes do not result in any initial pain (43% of cases in one study). Since the bite may not be immediately noticed, collection of the spider isn't seen as a necessity. As soon as 2 hours after the bite, the area may become painful, itchy, hot, swollen, red and tender. An irregular ulcerous sore, caused by necrosis, will often appear that is from 1/4 inch to 10 inches in diameter. Prompt attention is the best defense against preventing the necrosis. The wound is often described as being reddish and surrounded by a bluish area with a narrow whitish separation in between the red and the blue. This gives it the famous "bull's eye" pattern. 

When I was first bit, I didn't associate the high fever that I had the first day with the sore that appeared the next day. The second day I had a golf ball sized lump with an oozing center, the third day the lump was the size of a hockey puck and a dead tissue area the size of my little finger. After going to the hospital they prescribed 500 milligrams of penicillin four times a day along with hot salt water compresses which went on for over two weeks.

Source:  My butt day 2!

If the wound is becoming necrotic, it will often begin to turn purple within 24 hours. If the skin does turn purple, it is likely that necrosis is on the way and will then turn black as the cells die. Eventually, the necrotic core will fall off and leave a deep pit. A sinking blue-gray impression in the skin is the result. Gravitational flow may have an effect and result in pockets of necrosis in different areas of the body. 

Source: Alabama A&M University

Deep scarring can occur after healing. Scarring may look like a hole had been scooped out of the body. In some cases, necrosis can reappear months or even years after being bitten. Sometimes necrosis will reappear on a yearly basis. The photo on the right was taken several weeks after the initial bite. Our customers report that our First Aid Kit healed their necrotic wound and having a kit available from (https://www.brownrecluses.com) on hand prevents Necrosis from ever appearing.

Systemic symptoms

Those having the following symptoms are less likely to experience a necrotic wound. The theory is that the venom circulates through the bloodstream rather than being localized in the skin. These symptoms are:

• Fever

  This victim saw the spider on her foot as she got out of the shower. She eventually had to have her leg amputated below the knee. Bathtubs and showers are common locations for these spiders because they get trapped within the smooth surfaces.

• Chills
• Sweating
• Nausea
• Vomiting
• Joint Pain
• Jaundice
• Blood in urine
• Seizures
• Coma
• Kidney Failure
• Hemolysis

Not all bites will have the same effect. There have been cases where deaths were attributed to Brown Recluse bites, but it is not common. Secondary infections can occur. The degree of severity depends on:

• How much, if any, venom was injected.
• The overall health of the victim and strength of the immune system.
• The age of the victim. Children under 7 are particularly susceptible to life threatening reactions.
• Potential allergic reaction to the bite. 

 Medical Treatment

An antidote has been developed but is mainly effective within 24 hours after the bite. Since people typically only visit their doctor after the 24 hour window has expired, an antivenin has not been commercially available.

Photo taken 3  months after skin graft Source: Alabama A&M University

11 days after Brown Recluse bite Source: Dale Losher

A number of methods have been used by the medical community to fight the symptoms of a Brown Recluse spider bite. 

Emergency room treatment often consists of local debridement (removal of dead tissue), elevation, and loose immobilization of the affected area. Cool compresses are also sometimes applied to help slow the activity of sphingomyelinase D, the protein thought to be responsible for tissue destruction. A urinalysis may be conducted to check for evidence of systemic bite symptoms such as hemolysis. 

Corticosteroids, Dapsone, Antibiotics, Skin Grafting, and cutting out the surrounding tissue are other treatments frequently used. Antibiotics are probably the most common method and are typically prescribed to prevent infection. Staph and Strep infections can occur due to the open wound.  Amputation is also performed when necessary. 

Do not apply camphor, phenol, or other household disinfectants to a Brown Recluse bite wound. 
 

Recurring bite wounds

Brown Recluse bite wounds are known for returning even after it appears to have completely healed. One possible trigger of the recurrence is a bruise, scratch or other lesion near the previously wounded area. The wound can erupt in the same location as the original bite or in another area. The wounds can recur on a yearly cycle near the time of the year when the original bite occurred. It is believed that wounds return because the venom is still underneath the skin. Below are photographs sent to us from Cora Rich of Scott County, TN. She has a recurring bite wound that is in now in its 10th year of recurrence.