Spider bites send two to hospital

Secondary infections blamed, not poisonous arachnids

Posted: Monday, August 12, 2002

Four days after a spider bit him in his sleep in early July, Paul Schmid was in the emergency room for treatment of the swollen and festering bite wound. Three weeks later he was back at the hospital, receiving antibiotics for a second bite.

"I'm not sleeping in that room anymore, not after two bites," said Schmid, 20.

Schmid's experience highlights the fact that the bite of even nonpoisonous spiders sometimes can cause serious problems.

Schmid captured the arachnids. He suspected they were poisonous, possibly brown recluse or hobo spiders. Alaska Cooperative Extension Agent Jim Douglas examined the spiders and said they lack the distinguishing characteristics of either of those species.

Schmid said he was first bitten on his thigh in the house he rents on Goldbelt Avenue downtown. Over the course of four days the small, red welt with a tiny white center spot grew into a painful swollen lump 5 inches across. When the center started turning black, his housemates insisted he go to the hospital.

"It got infected and it abscessed," he said. "They had to cut it open and drain this gross pus out."

The wound healed. Three weeks later he woke up with another bite, this time on his ankle.

"The first two days it didn't really hurt, it just looked like a pimple. Then the third day it started hurting," he said. He went to Bartlett Regional Hospital for oral antibiotics, and after elevating his leg and icing the wound, the swelling came down. But a few days later it became inflamed and so painful he couldn't walk. Over the course of the next week, Schmid made a half-dozen trips to the hospital for intravenous antibiotics.

A seasonal worker, Schmid will return to South Dakota for college in a few weeks. He's decided to stay with his sister until he leaves.

"I don't know what it was, but it's definitely an experience I don't want to have again," Schmid said.

On July 19, her 17th birthday, Phoebe Rohrbacher of Douglas woke up with a small bite on her ear.

"It's just one of those things, you wake up in the morning with a spider bite and don't think anything of it," said her mother, Paula Gonzales Rohrbacher. "It's not like we have an infestation of venomous spiders."

Two days later Paula brought her daughter to the hospital. A serious infection had developed - her face was puffy, the redness had spread down her neck, her glands were swollen, and she was nearly delirious with fever. Phoebe spent four days lying in the hospital receiving IV antibiotics.

"She's doing much better," said Paula. "She was very ill."

Dr. Amy Dressel, a Juneau pediatrician, said the bite of a nonpoisonous spider usually causes redness and swelling and a small, hard welt that fades. Problems are the result of secondary infections.

"The spider's toxin can be irritating to the skin around the bite, and kids will scratch it and spread the toxin around or push the normal skin bacteria down into the wound and cause a secondary infection," she said.

Extension agent Douglas said a spider's bite also can inject bacteria picked up from the flies and insects that spiders eat, which infect the tiny puncture wounds.

The venom of black widows is a different story. Dressel treated black widow spider bites when she worked in Colorado and said they can cause serious tissue damage including necrosis, which is dead tissue.

"They're really nasty," she said. "Much more dramatic, much more tissue necrosis in the center, tissue dying and sloughing off. People sometimes even lose muscle tissue and require constructive surgery.

"Here I've seen mostly local irritation to the area, only once seen any kind of necrosis, and we cut the tissue out and it healed over time."

Dressel said a spider's venom is not really something like a bee sting that causes a systemic allergic reaction.

"That's incredibly rare," she said. "Reaction to other bug bites is much more common."

That has been Douglas' experience as well. He's seen physical reactions in people bitten by whitesocks and noseeums, tiny members of the black fly family.

"The first guess is often a spider, but there are people in Juneau who have had severe bites from whitesocks, and horse flies can create good sores," he said. "With a spider bite, a lot of times early on you can actually see the two fang puncture marks."

Dressel said very early on sometimes there's a little bubble of fluid visible under the puncture marks. She recommends as initial treatment for a spider bite to apply a warm washcloth as a compress to draw out the toxins and reduce the swelling. An over-the-counter antihistamine such as Benadryl can reduce itching, and Tylenol or Ibuprofin provides relief if the bite is painful.

Secondary infections are rare and are treated with antibiotics. Dressel said she's seen fewer than a dozen cases of spider bites in her three years in Juneau.

When it comes to dealing with unwanted spiders in the house, Douglas recommends soapy water and a vacuum cleaner, not pesticides. Vacuuming the cracks and crannies in the house with the vacuum's crevice tool is the first step. A teaspoon of liquid soap in a pint of water can be used in a recycled spray bottle to kill spiders.

"Spray soapy water into the cracks, you don't need to soak it," Douglas said. "The soap on their skin breaks down their skin. It kills them."

Even if there is a profusion of spiders on the outside of a house, Douglas doesn't advise insecticides. Just use the garden hose to take down the webs, he said.

"Wear gloves if you're working around a woodpile and watch where you put your hands," he said.

Douglas admits he finds spiders kind of creepy and he doesn't relish chores that involve crawling under the house or moving boxes around a basement. But he emphasized spiders in Alaska are not aggressive and bite strictly in self-defense.

"Ninety five percent of the spiders are very helpful," he said. "They keep the mosquito populations down. They are strictly out there cleaning up insects."

Riley Woodford can be reached at rileyw@juneauempire.com.

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