Brown Recluse Spider - Bite

Bite

As suggested by its specific epithet reclusa (recluse), the brown recluse spider is rarely aggressive, and bites from the species are uncommon. In 2001, more than 2,000 brown recluse spiders were removed from a heavily infested home in Kansas, yet the four residents who had lived there for years were never harmed by the spiders, despite many encounters with them. The spider usually bites only when pressed against the skin, such as when tangled within clothes, towels, bedding, inside work gloves, etc. Many human victims report having been bitten after putting on clothes that had not been worn recently, or had been left for many days undisturbed on the floor. However, the fangs of the brown recluse are so tiny they are unable to penetrate most fabric.

The bite frequently is not felt initially and may not be immediately painful, but it can be serious. The brown recluse bears a potentially deadly hemotoxic venom. Most bites are minor with no necrosis. However, a small number of brown recluse bites do produce severe dermonecrotic lesions (i.e. necrosis); an even smaller number produce severe cutaneous (skin) or viscerocutaneous (systemic) symptoms. In one study of clinically-diagnosed brown recluse bites, skin necrosis occurred 37% of the time, while systemic illness occurred 14% of the time. In these cases, the bites produced a range of symptoms common to many members of the Loxosceles genus known as loxoscelism, which may be cutaneous and viscerocutaneous. In very rare cases, bites can even cause hemolysis—the bursting of red blood cells.

49% of brown recluse bites do not result in necrosis or systemic effects. When both types of loxoscelism do result, systemic effects may occur before necrosis, as the venom spreads throughout the body in minutes. Children, the elderly, and the debilitatingly ill may be more susceptible to systemic loxoscelism. The systemic symptoms most commonly experienced include nausea, vomiting, fever, rashes, and muscle and joint pain. Rarely, such bites can result in hemolysis, thrombocytopenia, disseminated intravascular coagulation, organ damage, and even death. Most fatalities are in children under the age of seven or those with a weak immune system.

While the majority of brown recluse spider bites do not result in any symptoms, cutaneous symptoms occur more frequently than systemic symptoms. In such instances, the bite forms a necrotizing ulcer that destroys soft tissue and may take months to heal, leaving deep scars. These bites usually become painful and itchy within 2 to 8 hours. Pain and other local effects worsen 12 to 36 hours after the bite, and the necrosis develops over the next few days. Over time, the wound may grow to as large as 25 cm (10 inches). The damaged tissue becomes gangrenous and eventually sloughs away.

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    Thomas Szasz (b. 1920)

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