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SPIDER BITES RARELY FATAL

Q: Approximately two years ago, I discovered several tiny, light tan spiders in a box I was unpacking. I believe that one crawled up my leg and bit me.

Shortly afterwards, I felt a tingling and slight itching at the site. Some hours later the area became quite painful, inflamed and swollen. I treated it with over-the-counter medication, and eventually the sore healed, leaving a black spot.

Since then there have been two additional eruptions at approximately four month intervals, each approximately 1/2 -inch away from the last. The symptoms are exactly the same.

Do you think these were indeed a spider bite, and should I expect to have a recurrence every few months?

-- D.H.
A: Without seeing the spots you are describing, it's very difficult to even guess what you have. And even a trained dermatologist may have a difficult time after seeing them. But your description certainly incriminates the spiders, at least the first time it happened.

Almost all spiders have venom that is considered poisonous. Fortunately, the fangs of most species are too short or too fragile to penetrate human skin, or, if they can, the amount of venom is not enough to cause a major problem.

If the skin is penetrated, the toxin of most species causes only short-term local pain, redness and swelling. On the average, fewer than three deaths per year are the result of spider bites in the United States, and these are usually among children. The two most common sources of spider bites in the United States are the black widow spider and the brown recluse spider.

The bite of the brown recluse spider may cause little or no immediate pain, but pain often develops around the bite within an hour or so. Over the next eight hours, an area of discoloration resembling a bulls-eye surrounds the bite site. In most patients, nothing more develops and the area heals. A blister may develop at the site of the bite that becomes a slow-healing ulcer. Nausea and a general feeling of illness may occur.

In a very small number of people, the ulcer may grow larger, become infected and be accompanied by fever, destruction of surrounding tissue (necrosis), and very rarely kidney failure. In these cases many physicians recommend surgical repair of the bite site as the first step in treatment. Oral steroids are also recommended.

Black widow spiders don't cause tissue breakdown, but their venom can cause generalized muscle pain, muscle spasms and muscle stiffness. Rarely is this bad enough to require treatment at all. But in the very young and frail elderly, pain medications and muscle relaxants may help decrease the symptoms.

A common problem following spider bites, venomous or not, as well as with bites from any insect, is the development of a bacterial infection.

The most perplexing part of your story is the return of similar, nearby, symptoms and spots.

I suggest you get examined by a dermatologist, who may want to biopsy one of the spots to make a determination as to the cause.

Write to Allen Douma in care of Tribune Media Services, 2225 Kenmore Ave., Suite 114, Buffalo, NY 14207; or contact him at DRFamily@aol.com. This column is not intended to take the place of consultation with a health-care provider.

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