Spider Bites, Necrotic Arachnidism
Description Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: T63.3 DESCRIPTION Violin/recluse (Loxosceles) spiders and sac (Cheiracanthium) spiders can produce local necrotic skin lesions that are mediated by enzymes. DIAGNOSTIC CRITERIA Bites are initially painless. Skin lesions can vary from mildly erythematous lesions to severe local reaction, i.e. blis
Description
Diagnostic criteria
General and supportive measures
Medicine treatment
ICD-10 code: T63.3
DESCRIPTION
Violin/recluse (Loxosceles) spiders and sac (Cheiracanthium) spiders can produce local necrotic skin lesions that are mediated by enzymes.
DIAGNOSTIC CRITERIA
- Bites are initially painless.
- Skin lesions can vary from mildly erythematous lesions to severe local reaction, i.e. blistering, bluish discolouration progressing to frank necrosis.
- Systemic effects occasionally include nausea, vomiting, fever, chills, arthralgia, haemolysis, thrombocytopaenia, haemoglobinuria and renal failure.
GENERAL AND SUPPORTIVE MEASURES
- Supportive care.
- Surgical debridement may be required once the clear margins around the necrotic lesions are established.
MEDICINE TREATMENT
For pain:
- Paracetamol, oral, 15 mg/kg/dose, 6 hourly as required.
Antibiotic therapy for septic lesions.
Surgical debridement may be considered for large necrotic lesions.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 18: Poisoning, 18.2 Envenomation, 18.2.5 Spider Bites, 18.2.5.2 Spider Bites, Necrotic Arachnidism