Eight-legged scapegoat

Scientists say far too many wounds are blamed on the brown recluse spider - especially in regions outside its habitat.

Posted: July 02, 2007

Lounging on the hammock by her backyard woodpile, Jennifer Reynolds suddenly became aware of something behind her left knee. "I did not feel the moment I got bitten," she recalls. That was a Saturday. By Monday, people were commenting on her leg. By Tuesday, a hideous boil emerged.

At nearby Riddle Memorial Hospital's emergency room, two of the three doctors who examined her were convinced that this was the work of the notorious brown recluse spider. The previous week, the doctors told her, they'd cut out a piece of a patient's chest to prevent a similar wound from degenerating.

"My impression is that they are seeing many more of these," says Reynolds, who discovered after a two-night hospital stay that a neighbor in Rose Valley had been bitten a year ago.

Indeed, at least 158 brown recluse spider bites have been reported to Pennsylvania poison control centers, says medical director Kevin Osterhoudt.

Paradoxically, virtually no brown recluse spiders have been found.

Osterhoudt and his fellow arachnid myth-busters are on a mission to debunk the assumed ubiquity of the brown recluse. These scientists and doctors want to get the word out that - in regions outside the spider's habitat in parts of the Midwest and Southwest - other ailments that induce a bite-like wound should be ruled out before conjuring the recluse.

Brown recluse bites are known for necrotic wounds - injuries surrounded by dead tissue - but then so are lots of other things. Osterhoudt, a medical toxicologist at Children's Hospital of Philadelphia, has an idea about how the recluse became the necrotic-wound scapespider.

"I think starting right off in medical school, doctors learn that brown recluses cause necrotic wounds. We all have our spider fears. So spider stuff sticks in your head. The fourth pathway in the Krebs cycle may not be remembered as well," he says, referring to an often-memorized and then forgotten step in cellular metabolism.

The danger of misdiagnosis is that a more serious illness may be missed. In 2002, Osterhoudt published the example of a 9-year-old Philadelphian who was treated for a recluse bite that turned out to be Lyme disease.

"A recluse bite usually heals by itself, but you miss Lyme disease and you can have a severe debilitating condition," says Rick Vetter, an entomologist at the University of California-Riverside and the unofficial leader of the recluse truth brigade.

Anthrax, skin cancer, flesh-eating bacteria, and staph infections have all been pinned on Loxosceles reclusa. A 2006 article in the New England Journal of Medicine showed that 29 percent of patients who were eventually shown to have an antibiotic resistant strain of Staphylococcal aureus had initially blamed a spider bite.

Once people get medical corroboration that they've been bitten by a brown recluse, the myth spreads in a new way.

"If you got a staph infection, you wouldn't tell anybody," Vetter says. "If you got a brown recluse bite, you'd tell everybody! You'd put it in your Christmas letter."

The news media amplify the fairy tale. A 2002 Inquirer article about former Phillies third-baseman Dave Hollins' getting bitten by a brown recluse was headlined, "Flare-up of spider bites puts Hollins on 15-day DL."

"A brown recluse bite is a very sexy diagnosis," Vetter says, adding that it "becomes a badge of courage for the rest of their lives."

In this part of the country, the brown recluse is far from home. Its range is typically from Texas north to Iowa and east through Kentucky. Rose Valley, the Delaware County community where Reynolds lounges in her hammock, is about 550 miles from the spider's territory.

Irrational fear of the recluse is nationwide. "You can't have brown recluse spider bites without recluse spiders," says Vetter.

Studies in California, Florida, and South Carolina - all states well outside the recluse's domain - have found numerous reports of bites but very few if any brown recluse spiders.

In regions where it is established, the recluse is prolific, yet rarely envenomates people. Working with Vetter, a family in Kansas - where the spiders are endemic - caught more than 2,000 brown recluses in six months without receiving a single bite.

He and his colleagues are presenting their Pennsylvania and South Carolina findings at the American Arachnological Society's annual meeting this month at Susquehanna University in Selinsgrove, Pa.

Part of the presentation is Osterhoudt's compilation of 158 brown recluse bite reports to Pennsylvania's two poison control centers.

Doesn't that prove recluses are here? Actually, anyone can report a recluse bite to the poison control center - no evidence is necessary. And since doctors aren't required to report them, Osterhaudt says, 158 "vastly, vastly underrepresents the actual number of brown recluse bite diagnoses."

While lecturing to local medical professionals, Osterhoudt recalls, he asked how many had diagnosed recluse spider bites in the last year. "Ninety percent raised their hands."

And how many actual brown recluses have been found in Pennsylvania?

"We've had two submissions in over 20 years," says Steve Jacobs, an entomologist at Pennsylvania State University. That's out of an estimated 300 that were sent in by people who wanted verification of their recluse find.

Jacobs, who works with Osterhoudt and Vetter, says that over the same period he received three scorpions that apparently had hitchhiked into Pennsylvania.

Osterhoudt himself has received dozens of submissions, but not a single one turned out to be a recluse.

Vetter two years ago published the results of his own "recluse challenge." On his spider Web site, he asked people to send in their purported recluses for expert identification (the offer remains open). He received more than 1,700 submissions from across the country. Of those found outside the spider's habitat, however, only three were brown recluses (all from one shed in Virginia).

Reynolds, whose wound is now healed, has done some of her own recluse research. "These spiders love wood piles," she says, and her hammock is near a pile of wood.

During a Little League game a week or so after her trauma, Reynolds shared her story with Bill Keffer, her son's coach. He said he'd had a similar experience last summer and knew all about the notorious brown recluse.

The two doctors who Reynolds says were sure that the wound was from a brown recluse did not return phone calls last week. A spokeswoman for Riddle Memorial said Friday that no one at the hospital had been diagnosed with a brown recluse spider bite.

Keffer says his doctors hadn't actually been certain that a brown recluse was involved. Even so, "it's cooler to say I got bitten by a brown recluse spider than I just have a regular nasty infection on my leg," Keffer says. "Never let the truth get in the way of a good story."


 

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