Document Detail


Brown recluse spider bites to the head: three cases and a review.
MedLine Citation:
PMID:  15372917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Consequences of envenomation from the bite of a brown recluse spider (Loxosceles reclusa) range from mild itching to death. The bite of this spider causes the most severe form of arthropod-induced tissue necrosis. These bites pose several challenges to the clinician in that diagnosis can be difficult, systemic manifestations can occur, and healing can be resistant to conventional measures. Bites to the head and neck-particularly the face-are uncommon, and they have not been widely reported in the otolaryngology literature. As experts in facial soft tissue, otolaryngologists and facial plastic surgeons should be able to recognize and treat these lesions. Because no laboratory test is available to identify the cause of symptoms in these cases, the diagnosis is made clinically. Early intervention can make a significant difference in cosmetic outcome, so a high index of suspicion is warranted. Local wound care includes rest, ice, compression, and elevation of the affected part of the body. Drug therapy with dapsone may limit the severity of the bite and prevent complications. Because some bites cause systemic loxoscelism, clinicians should be familiar with its manifestations. When necrosis occurs despite adequate medical treatment, reconstructive procedures should be delayed until healing is complete. We report 3 cases of brown recluse spider bites to the head. These cases illustrate the broad spectrum of the disease course, and they highlight the therapeutic challenges that these lesions pose.
Authors:
Joseph Leach; Benjamin Bassichis; Kamel Itani
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Ear, nose, & throat journal     Volume:  83     ISSN:  0145-5613     ISO Abbreviation:  Ear Nose Throat J     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-09-17     Completed Date:  2004-11-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7701817     Medline TA:  Ear Nose Throat J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-70     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas 75390, USA. joseph.leach@utsouthwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Arachnidism / pathology*,  therapy
Female
Humans
Middle Aged
Phosphoric Diester Hydrolases / poisoning*
Spider Venoms / poisoning*
Chemical
Reg. No./Substance:
0/Spider Venoms; 0/loxosceles venom; EC 3.1.4.-/Phosphoric Diester Hydrolases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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