Necrotizing fasciitis developing from a brown recluse spider bite
Majeski, J.
American Surgeon 67(2): 188-190
2001
ISSN/ISBN: 0003-1348 PMID: 11243548 Document Number: 532931
A 20-year retrospective case series [South Carolina, USA] was analysed to identify the brown recluse spider bite [Loxosceles reclusa] as a cause of necrotizing fasciitis. Data from 31 consecutive patients with necrotizing fasciitis were analysed. A brown recluse spider bite was found to be the initial cause of the necrotzing fasciitis in 2 patients. Both patients delayed obtaining medical treatment, and secondary infection of the necrotic tissue occurred. One patient was diagnosed by frozen section tissue biopsy, and the second patient was diagnosed by clinical examination. All patients in this series had immediate aggressive operative debridement. Both patients survived with functional limbs. There were no deaths in this large series. Necrotizing fasciitis can be caused by a secondarily infected brown recluse spider bite. Successful treatment of necrotizing fasciitis from any cause is associated with early diagnosis, immediate surgical debridement, and supplemental enteral or parenteral nutrition.