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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18668
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Recluse spider bite on the upper neck at base of scull that

Customer Question

brown recluse spider bite on the upper neck at base of scull that is getting worse after a week...
Submitted: 2 years ago.
Category: Medical
Expert:  eclimber replied 2 years ago.
Hi there, this is Dr. Elaine
If this is truly a recluse bite, a lot of tissue damage (called necrosis) can occur weeks down the line from the bite itself.
If infection has set in, there could also be a bacterial strain that is resistant to the antibiotic you are giving. If this is the case then a test called a culture and sensitivity may need to be done. This can determine what bacteria we are dealing with, and what antibiotic is likely to be most effective against it.
That said, if tissue necrosis is occurring, more surgery may be required to remove dead tissue. Antibiotics can not reach areas that are devascularized (lacking blood supply) from necrosis, and the toxins from such tissue can enter the bloodstream, potentially causing septicemia/toxemia.
I don't see another option from what you describe than to have your pet re-examined to determine the next logical step. There may well be several options, but you won't know until he/she is seen again.
Let me know if I may answer anything further.
Dr. Elaine
Customer: replied 2 years ago.
Doctor, it was not a cat that got bite, but a human, as have explained in my first email...the injured person is a is a white female, 50 years old in good health. we are almost certain that is was a brown recluse. it is high on the neck at the base of the skull and close to the spinal has been a week and it is not getting better but worse. A large knot is forming and growing on the neck. it hurts her a lot.
she went to the urgent care last Friday (bite occurred last Wednesday)
they gave her a antibiotic med and some pain pills, it still hurts a lot. she went to the emergency room today/late after
Customer: replied 2 years ago.
today they drained the wound at ER and gave her more antibiotics through an IV, but did not admit her. they sent her home and she is hurting a lot. what should she do?
Customer: replied 2 years ago.
still waiting for an answer...
Expert:  Dr. D. Love replied 2 years ago.
I am sorry about the confusion about the category.
However, the basic treatment for a brown recluse spider is the same for humans as for animals. It is important to surgically remove any dead tissue, as antibiotics will not be effective if there is any dead tissue. If there is any collection of pus related to infection, then drainage is appropriate. Antibiotics will treat the infection, but whether the antibiotics should be given orally or intravenously would depend upon the severity of infection.
After performing the drainage today, then the antibiotics will usually do better at getting control of the infection, but it is common for it to take 2-3 days for significant improvement to be seen.
For the pain, it would be fine to use any of the over the counter pain medicines. Stronger pain medicines also can be used, but would require a prescription. It also may help to apply ice packs or moist heat to the are, as the ice can help ease swelling and the moist heat can help ease inflammation associated with the infection.
If I can provide any clarification, please let me know.