Diferencia entre revisiones de «Brown recluse spider bite»

Revisión del 23:25 11 mar 2015

Bite is initially painless
Mild reaction
- Most common
- Mild erythematous lesion that later becomes firm and heals without scar
Severe reaction
- Begins w/ mild-severe pain several hrs after bite accompanied by erythema and swelling
- Hemorrhagic blister then forms surrounded by vasoconstriction-induced blanched skin
- By day 3 or 4 hemorrhagic area may become ecchymotic
  - Leads to "red, white, and blue" sign (erythema, blanching, ecchymosis)
- By end of first week ecchymotic area may become necrotic w/ eschar formation
Systemic effects
- Rare
- Occur predominantly in children 24-72hr after the bite
  - Include nausea/vomiting, fever, arthralgias, DIC, rhabdo, renal failure

Local wound care
Abx are indicated only if signs of infection exist; secondary infections are uncommon
Although some texts recommend Dapsone, it has been shown to be of limited benefit and is associated with hemolysis in G6PD patients and als methemoglobinemia

Authors:

@@ Línea 8: / Línea 8: @@
 ==Clinical Features==
-#Bite is initially painless
+*Bite is initially painless
-#Mild reaction
+*Mild reaction
-##Most common
+**Most common
-##Mild erythematous lesion that later becomes firm and heals without scar
+**Mild erythematous lesion that later becomes firm and heals without scar
-#Severe reaction
+*Severe reaction
-##Begins w/ mild-severe pain several hrs after bite accompanied by erythema and swelling
+**Begins w/ mild-severe pain several hrs after bite accompanied by erythema and swelling
-##Hemorrhagic blister then forms surrounded by vasoconstriction-induced blanched skin
+**Hemorrhagic blister then forms surrounded by vasoconstriction-induced blanched skin
-##By day 3 or 4 hemorrhagic area may become ecchymotic
+**By day 3 or 4 hemorrhagic area may become ecchymotic
-###Leads to "red, white, and blue" sign (erythema, blanching, ecchymosis)
+***Leads to "red, white, and blue" sign (erythema, blanching, ecchymosis)
-##By end of first week ecchymotic area may become necrotic w/ eschar formation
+**By end of first week ecchymotic area may become necrotic w/ eschar formation
-#Systemic effects
+*Systemic effects
-##Rare
+**Rare
-##Occur predominantly in children 24-72hr after the bite
+**Occur predominantly in children 24-72hr after the bite
-###Include nausea/vomiting, fever, arthralgias, DIC, rhabdo, renal failure
+***Include nausea/vomiting, fever, arthralgias, DIC, rhabdo, renal failure
 ==Differential Diagnosis==