Brown Recluse Spiders: how hard can it be to find one?

mycrofft

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From the University of Wisconsin medical website, a male recluse on a quarter:
b1...alerecluse.jpg

And from my alma mater, the University of Nebraska, a female on a quarter:
emtlife

And a map of the renge of Loxoceles species, the red zone being where the Brown Recluse is found:
emtlife

from Dr. Ken Cramer, Brown Recluse ID Project
Dept. of Biology, Monmouth College
Monmouth, IL 61462

There is a very good thread in here about MRSA. I mention this because often pts will attribute initial MRSA lesions to "brown recluses" or other spiders. In fact, one website I looked at for this showed an obvious staph lesion and described it as a reclusa bite. LA Cuonty Jail had a huge problem with inmate either believing or stating they beleived that they were experincing spider bites, when they were actually Staph aureus, and DNA proved they were from the community.

So, tell me, how do you differentiate and how does it affect your emergent treatment and personal protection?

(PS: siedbar: why can't a spiderbite become MRSA infected?).
 
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mycrofft

mycrofft

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I am asking to repost this later with photos

I will include URLS here if this is a burning question for you. Photos used withouty permission:

Male recluse, by Univ of Wisconsin;
http://apps.uwhealth.org/health/adam/graphics/images/en/19570.jpg

Female recluse, Univ of Nebraska:
https://depts.washington.edu/nwst/publish/stories/2006-fall/2006-fall-nwexplorer-1-brownrecluse.jpg

Distribution map:
http://images.google.com/imgres?img...wn+recluse+map&hl=en&rlz=1T4DKUS_enUS253US253


My apologies for the inconvenience.
 
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reaper

Working Bum
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They need to update that coverage map, N. FL is loaded with them. People need to realize that they don't bother humans that often. Unless you mess with them.

BTW- Gotta say, "GO BIG RED"

Home town is Cook,NE
 

BossyCow

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In my state recluse spider bites are pretty common. I don't see a lot of it in EMS because they tend to develop slowly and are generally treated and diagnosed in a Dr's office instead of as an emergency.

Initially the bite is not really noticable. Since the Brown Recluse gets its name from its habit of hanging out in out of the way places, often the person bit doesn't even see the spider who bit them.

I know of three people who have been bitten. Two from reaching into the woodpile for firewood in the dark, dank days of winter and the other was an electrician who was under a house on a wiring job. In all three cases, they didn't initiallly notice it as anything other than a small injury. One thought it was just a splinter. Within 24 hours the toxin progresses to the point where they know something is wrong. I think a lot of the problems with the recluse toxin is that it starts out as a small thing and really gets a chance to get a grip before the pt seeks treatment.
 

ffemt8978

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In my state recluse spider bites are pretty common. I don't see a lot of it in EMS because they tend to develop slowly and are generally treated and diagnosed in a Dr's office instead of as an emergency.

Initially the bite is not really noticable. Since the Brown Recluse gets its name from its habit of hanging out in out of the way places, often the person bit doesn't even see the spider who bit them.

I know of three people who have been bitten. Two from reaching into the woodpile for firewood in the dark, dank days of winter and the other was an electrician who was under a house on a wiring job. In all three cases, they didn't initiallly notice it as anything other than a small injury. One thought it was just a splinter. Within 24 hours the toxin progresses to the point where they know something is wrong. I think a lot of the problems with the recluse toxin is that it starts out as a small thing and really gets a chance to get a grip before the pt seeks treatment.

Are you sure about that? According to the UofW Extension office, there has only been one documented case of a brown recluse bite in WA state, that happened in Prosser in the 70's.
 
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mycrofft

mycrofft

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All spiders use toxins, some cause ulcers. Here's a culprit:

The Cheiracantium spiders are universal throughout the USA, often live in and around our homes. You will also see them outside when the weather's fair. They rarely have a legspan as large as a nickel. This family's members are somewhat variable but tend to be pale yellow/tan with sometimes a little green or darker tan thrown in.
An article about them:
http://www.canadianarachnology.org/data/spiders/23374
The bite is often missed because it is painless. I think since it's easier to say "Violin Spider" (there are a few with "violins") or "Brown Recluse" than "Cheiracanthium" (Kayer-uh-Kanthee-yum), that those brown Loxoceles spiders get the bad press.
 
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firetender

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Apparently, the most common place to find a brown recluse spider is on a quarter.
 

Ridryder911

EMS Guru
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There is a very good thread in here about MRSA. I mention this because often pts will attribute initial MRSA lesions to "brown recluses" or other spiders. In fact, one website I looked at for this showed an obvious staph lesion and described it as a reclusa bite. LA Cuonty Jail had a huge problem with inmate either believing or stating they beleived that they were experincing spider bites, when they were actually Staph aureus, and DNA proved they were from the community.

So, tell me, how do you differentiate and how does it affect your emergent treatment and personal protection?

(PS: siedbar: why can't a spiderbite become MRSA infected?).

Any wound can become infected and possibly infected from staph then one can become MRSA + with the staph. NOT all Staphylococcus Aureus becomes MRSA; only those that build an immune against methicillin. It becomes resistant to numerous antibiotics of the beta-lactam family, including methicillin and penicillin.

Now in regards to your Brown Recluse/Fiddle Back question. I have commonly treated at least one to two a day in my area (no joking). It is a very common spider and usually many people get bitten and never know it.

Each bite is unique and as well responds to the venom differently. In fact, determined if the patient has been bitten before; one can see different results.

Most of the time, it has been several days when we see clinical symptoms of a spider bite. Usually they have what we call the "bulls eye" appearance. Black in the center with multiple rings of various erythematous coloring (various redness) with swelling and possibly raised areas. The bite itself when occurs is usually painless. It is the toxin that causes the problem.

Unfortunately, the "black" in the center is usually necrosed tissue. It is hard to predict how much tissue loss will occur, if any. Sometimes it may be as small as a pimple to as large as a golf ball. I have debrieded, irrigated as well as packed many bites. We usually place the patient on prophylactic antibiotics such as Duricef and some may use the broad spectrum approach of Rocephin I.V. and steroid use. Again, we see several hundred cases and really there is very little change in any of the treatment regime. Usually, it all depends upon the amount of toxin, area of bite, and patients resistance.

MRSA should NOT be confused with a Brown Recluse bite alone. Yes, some patients do become MRSA after being treated conventionally with the antibiotics I described, but again they become resistant and develop an resistance with the associated S. aureus and are NOT the same. Anyone can develop MRSA from any infection, wound opening (laceration, puncture, bite) from any insect, spider, lesion, etc.. even mosquito bites. Again, it is not the route rather the infection after the bite that causes the MRSA.

Remember, one can also develop the common impetigo, and even malaria from mosquito's. (Yes, it's still common)

R/r 911
 
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apagea99

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We had an infestation of them in our last house. The pest control people had us clean out every closet in the place and we had to shake out and wash all of our hanging clothes and linens(the worst was that we would find them down in our sheets on occasion!!!!). Then they set out glue traps, sprayed, and put out some sort of white powder in the closets and corners. All that....and neither of us were ever bitten.
 

Buzz

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We're generally pretty safe from them up here... They can't live in temperatures below 40 degrees Fahrenheit, so the only reported instances of a breeding colony were within heated buildings that likely received materials from the south.

Now northern black widows on the other hand... :ph34r:
 
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mycrofft

mycrofft

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Firetender, I'll accept all your change, the babies favor dimes.

;)............
 
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mycrofft

mycrofft

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Ridryder, right on.

In fact, since staph likes to dissolve everything except fibrin before it sponges it up for dinner (hence the "plug" in staph abcesses I'm told, made of fibrin and white cells) the only impediment I see to staph in necrotic spider bites, either chiearachanthium or loxoceles, are that they are open (oxygenated) and that y'all swamp 'em with antibiotics, as we do too.

Inmates and drug offenders or abusers will often dismiss skin lesions and abcesses as "spider bites", either through ignorance or "peer counseling", and use that as a basis to sue law enforcement or medical authorities.
 
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mycrofft

mycrofft

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apagea99, sorry about that.

Killing spiders wholesale is tough, they don't drag their abdomens through toxins, they have tough chitinous exoskeletons with fewer means for poisons to get on board. Glue traps help, frequent cleaning and denying them habitat works, the other measures are there to eliminate their food (they don't live with you and sally out to the yard at night for chow). Ultrasonic devices...not scientifically proven to work.

Littlerock HS in Arkansas once had to shut down due to an infestation, I read in a paper there about 1970.
 
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mycrofft

mycrofft

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Buzz, tell me about black widows!

I'm sure Sapphyre and others have some stories. My "whale tail" is this: I was bucking hay one evening at dusk, and was going to do one more row before knocking off. I saw a mousehole on the next bale, went to shove the bale away from the wall with my hand then swing a hook into it, and that mousehole moved! I've also found them in mailboxes, drinking glasses, gopher holes, outhouses, seams in the drop ceiling of our medical housing unit at work, etc.

I have since learned accidentally that if you hit them real fast barehanded, like a backhand, you can kill them without being bitten.:ph34r: Not recommended. See the excellent thread on black widows elsewhere in EMTLIFE though.
 
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mycrofft

mycrofft

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Reaper, "Husker du!" and "Sc@%w football!".

http://urbanlegends.about.com/library/blspider-2002.htm
Urban Myth: BUSTED!
 
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mycrofft

mycrofft

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Bossycow, do these lesions have a central "plug" when they get going?

That could be staph. There are other ulcerative spider bites, some from species that effect everyone, and some which affect only some. In theory, some poeple don't respond and we would not know because, well, they don't respond. I respond to the Cheiracchanthium species, and I know it because I've seen them in my clothes and seen the bite later. If I didn;'t know the diffrence I'd have suspected staph.

Just to complicate it, there are also "biting" centipedes that can leave an ulcer. Very painful though by all accounts.
 
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mycrofft

mycrofft

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Oh, and Ridryder...West Nile Virus.

...................
 
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mycrofft

mycrofft

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...and from now on, Cheiracanhtiumwhatever is "CH spider"!!

;)............
 

daedalus

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There is some very conflicting information regarding the incidence of brown recluse. University websites are commonly conflict with eachother on the number of bites, some saying common, some saying exceedingly rare. They even conflict on the severity of the bites, some saying there is rarely a reaction, to others saying severe reactions occur. While reading the Mosby paramedic textbook, I noticed multiple and slightly serious errors in the description of black widow spiders. Mosby even goes as far as to say that black widow spiders almost always eat their male mate, while it is known to biologists that black widows RARELY ever bite or kill their male mates. With all this confusion, I doubt highly that any one of us could accurately diagnose a spider bite.

Don't believe me? google up brown recluse and compare the wikipedia article to ohio university's page, and than, compare them both to all the other .edu and .org. Very inconsistent. And you can forget about anything you learned in the toxicology section of your textbook because its almost all wrong.
 
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mycrofft

mycrofft

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daedelus if it wasn't obstruse, would universities bother writing about it?

;)
Yeah, seen 'em. It's not like we can go get volunteers to be bitten by pre-identified spiders and compare the clinical results, so tx has been empiric. I remember that some sources used to say to administer calcium gluconate to black widow victims...but if the Ca's being blocked, that seems to make poor sense, just get the side effects and get accentuated whiplash effects later as the blockers unblock?

One thing about field EMS tx for "spider bites": there is no real treatment except consider them to be infectious, reassure the pt, adminster analgesia as allowed, and go to the hospital with the best history and observations you can bring. Almost all field treatments suggested by anyone higher up the ladder than the ER is suspect and probably not going to make difference in the field.
 
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