My idea for this blog came to me while reminiscing about what happened yesterday. I had been changing out the pool filters, wearing my beloved Crocs. I had been standing in some low ground cover while doing this and was mostly worried about stepping on a friendly Dekays Brown Snake that frequents my yards. About 10 minutes afterwards, as I was going down my steps into my garage, I felt a sharp sting to my left great toe. I thought it may have been a mulberry thistle as they puncture my shoes quite often. I repositioned my foot, then a much sharper burn occurred. Oh, the pain!! I quickly took off my dear Croc to see a small, tiny black spider fall and run under my storage shelves. On examination of my toe, there was initially one very small area of redness (in the location of the first sting) and a much larger area of redness that was slightly raised to the lateral portion of my toe. The pain was a "burning, shooting" type pain that radiated to the top of my foot. I wondered how such a small little culprit could cause so much pain!? I cleaned the area with mild soap and water and applied a cool compress over the bite for 15 minutes. I elevated my foot and applied some AAA ointment, took a Motrin 800. There was no itching, but if there had been, I would have taken Zyrtec or Benadryl. I did have some mild nausea, but I wrote this off as due to the excitement of the whole event, and due to the concern, that it may have been a Black Widow. I have never really had a fear of spiders, actually think they are kind of cute. But now, I definitely can relate to why some folks have Arachnophobia! Brown Recluse bites are extremely rare here in Georgia, but they do happen. I have only seen 2 actual brown recluse bites during the last 18 years in Emergency Medicine. My symptoms were consistent with what would be of a typical house spider. Black Widow spider bites can include, redness, pain, swelling, severe abdominal rigidity or cramping, nausea, vomiting, tremors or sweating. Brown recluse spiders can include at first, a mild pain, fever, chills and body aches, a deep blue or purple area around the bite which may develop a red ring around it. Later, within 24 hours, tissue necrosis can occur to the central area of the bite. Any spider bite can become infected, especially the ones that itch because people tend to scratch the area and we all have bacteria under our fingernails. I have treated numerous infected bites in the ER. Signs of skin infection/cellulitis include swelling, worsening redness, worsening pain, and streaking. When this occurs, antibiotics are usually needed to resolve the infection. You may even need a tetanus shot, which can be prescribed to your local pharmacy for distribution. Fortunately, I "still have my toe" this morning, and there are no signs of necrosis or infection. As much as I love my Croc's, the little holes in them doesn't keep the intruders out. I wish you a "spider free" life, but if you should become a victim, schedule a virtual visit with me at Urgentvirtualclinic.com. Melissa D. Roberts, PA-C / CEO Urgent Virtual Clinic LLC
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