Brown recluse spiders can be found across the central and southern United States, including Missouri. They typically become more active in the warmer months, with a peak season between March and October. Spider bites are fairly common in Missouri, but brown recluse bites are more dangerous than most common spider bites.
When parents bring their children to the emergency department concerned about a spider bite, it usually isn’t a spider bite. Instead, most cases are skin and soft tissue infections such as cellulitis or abscesses. But children do come into our emergency departments with complications from brown recluse bites and sometimes need admission to the hospital.
Brown Recluse Spiders
These spiders have been described as yellow-brown in color, with a violin-shaped mark on their head. They prefer to hang out in dark, quiet areas like the basement or attic. They are not aggressive but bite when they think they are being attacked. Often, people will unknowingly put on clothes or shoes with a brown recluse hiding inside. They also may accidentally roll over a brown recluse that is climbing onto the bed sheets. The brown recluse will bite as it is crushed against a person’s skin.
Common Symptoms of Brown Recluse Spider Bites
People who have been bitten by a brown recluse initially report mild pain and itching. This pain may become worse over the next several hours. The classic brown recluse bite presents itself as an area of central necrosis (or tissue breakdown), surrounded by a pale ring, followed by an outer red ring. The central area can have tiny clear bumps before the tissue breakdown begins. It’s thought that the area of tissue breakdown is related to the amount of venom injected into the skin. Most of the time, these bites will heal on their own. Although sometimes, patients with large, deep wounds need a referral to wound care specialists or dermatologists. How quickly the wound heals depends on the size of the wound, but most people do not become seriously ill.
Concerning Symptoms of Brown Recluse Spider Bites
Rarely, children bitten by a brown recluse can become very ill if they develop loxoscelism, which is when the venom affects several systems in the body. This can present itself as fever, chills, abdominal pain, nausea, vomiting, joint pain, jaundiced (yellow) eyes, and a change of urine color. In addition, it can cause kidney damage and red blood cell breakdown, leading to severe anemia. The good news is that this is rare. The bad news is that younger children are more likely to develop these severe effects.
Treatment for a Brown Recluse Spider Bite
Any patient, particularly children, with a suspected brown recluse bite needs to be assessed to ensure their vital signs are normal and that they have no concerning signs (such as fever, nausea, abdominal pain, yellow eyes, or dark urine). A child with a brown recluse bite with some of the concerning signs described above needs to be hospitalized. Children who have the symptoms of a classic bite, who are otherwise well, can usually be discharged home from the emergency department after careful examination. If discharged home, patients should follow up with their doctor to make sure the wound is healing well. However, they should return to the emergency room immediately if they develop any concerning symptoms described above.
Preventing Spider Bites
The best way to prevent a brown recluse bite is to avoid contact with them. Always shake any shoes or clothes that have been on the floor before putting them on to confirm no creature is tucked inside.
If your child experiences symptoms related to spider bites, all caregivers should know your preference for which hospital a child should be taken to in case of an emergency. Our Washington University Children’s After Hours locations provide convenient medical care for your child’s illnesses and injuries as a faster alternative to ERs when your pediatrician’s office is closed.
In case of a medical emergency with a child, determine where the nearest accredited, Level I pediatric trauma center is located. St. Louis Children’s Hospital has six pediatric ER locations across the St. Louis and southern Illinois region including St. Louis Children’s Hospital, Children’s Hospital at Memorial Hospital Belleville, Children’s Hospital at Memorial Hospital Shiloh, Children’s Hospital at Missouri Baptist Medical Center, Children’s Hospital at Northwest HealthCare, and Children’s Hospital at Progress West Hospital.
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