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Spider Bite: Brown Recluse Spider Bite (cont.)

What is the follow-up for a brown recluse follow-up?

After the initial evaluation by a doctor, the patient may expect this type of follow-up:

  • Daily follow-up of wounds for the first 96 hours to assess the possibility or extent of necrosis (tissue death) of wound
  • Hospitalization for people with systemic disease
  • Continuation of antibiotics until secondary infections clear
  • Follow-up with a surgeon if necrosis of the wound is evident

How do I prevent a brown recluse spider bite?

Reducing the possibility of an encounter with a brown recluse spider starts with eliminating known spider habitats.

  • Perform routine, thorough house cleaning.
  • Reduce clutter in garages, attics, and basements.
  • Move all firewood, building materials, and debris away from the home's foundation.
  • Install tight-fitting window screens and door sweeps.
  • Clean behind outside home shutters.
  • Consider installing yellow or sodium vapor light bulbs outside entrances because these lights are less attractive to insects and draw fewer spiders to the area.
  • Consider professional pest elimination.

What is the prognosis for a brown recluse spider bite?

The majority of brown recluse bites cause little permanent skin damage, although, in some cases, moderate to severe tissue destruction is possible. The full extent of damage to tissues is not known for days. It may take many months for the wound to completely heal.

  • Brown recluse bites are noted for somewhat slow development of signs and symptoms, and often take up to 12 hours to reveal themselves. Necrosis of skin (death of skin), if it occurs, does so in the first 96 hours. Bites older than this that do not display tissue death have not been reported to worsen.
  • Necrotic lesions can be difficult to manage, and early surgery to remove dead tissue has not been shown to improve outcomes. Necrotic lesions with careful cleaning are allowed to mature for weeks until spreading stops and healing appears to begin. Then a wide area of tissue around the wound is removed and skin grafting may be done once all evidence of skin necrosis has subsided.
Last Reviewed 8/30/2017

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Read What Your Physician is Reading on Medscape

Spider Envenomations: Brown Recluse »

In the United States, reports of severe envenomations by brown spiders began to appear in the late 1800s, and today, in endemic areas, brown spiders continue to be of significant clinical concern.

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