Closets, attics, boxes, and basements are favorite urban settings for the brown recluse or fiddle back spider. Deemed more of a public health menace than the black widow or any other arachnid, the brown recluse is surprisingly non-aggressive and won’t attack unless threatened.

At first, a person bitten by a brown recluse may only notice irritation on the skin. After two to eight hours, the affected area becomes a papule (a small raised, solid swelling, typically inflamed but not producing pus). The papule turns white from the localized thrombosis, vasoconstriction and infarction of the tissue. A bite from the brown recluse causes a complex problem wound that can lead to significant tissue necrosis if left untreated.

Other brown recluse spider bite symptoms include:

• Fever

• Chills

• Rash

• Nausea

• Hemolytic anemia

As time passes, the skin lesion becomes more evident with the development of a hemorrhagic vesicle.  Subsequently, the vesicle will rupture and form a black crust. As the crust sloughs, it has a necrotic ulcer that can extend through the subcutaneous fat and expose muscles and fascial planes. These disfiguring ulcers can be up to 25 cm. Treatment includes compression, ice, elevation, surgical debridement, antibiotics, and hyperbaric oxygen therapy administered early to avoid the wound from progressing.

Victims of brown recluse spider bites benefit from adjunctive hyperbaric oxygen therapy by its ability to:

• Improve wound healing by supersaturating the body with oxygen.

• Boost the efficacy of antibiotic treatment.

• Promote collagen production and angiogenesis to get hyper-oxygenated blood to the affected area.

WHEN TO CALL HYOX:

• Within two to six days - in the early stage of ulceration from the spider bite. Unfortunately, the diagnosis of spider bite-related ulcers is often delayed and weeks or months may elapse before hyperbaric oxygen is considered.