DEATHS: 4-5% of untreated cases due to neurotoxic effect of the venom
TREATMENT
LOCAL FIRST AID: Ineffective and unnecessary
SYSTEMIC:
1. Antivenin—1 vial IM (carefully follow package insert instructions) after testing for horse-serum sensitivity 2. Calcium gluconate—10 ml of 10% solution given IV immediately and prn to control muscle pain 3. Muscle relaxants—Give continuously over 8-16-hr period to relieve intensity of muscle spasm and pain 4. Treat for shock as necessary ([Chart 2])
[BROWN RECLUSE SPIDER]
REACTIONS
IMMEDIATE: Very little pain, if any
LOCAL:
1. 2-8 Hours—Mild to severe pain with redness and vesiculation at bite site, followed by ischemia 2. 3-4 Days—Star-shaped firm area of deep-purple color with necrosis 3. 7-14 Days—Central area of depression and ulceration 4. 21 Days—Healing and scar formation. May not heal sufficiently and may require skin grafting