CLINICAL PRACTICE GUIDELINES (FULL LIST)
BROWN RECLUSE (CPG)
Brown Recluse Spider Bite (Loxoscelism):
Loxoscelism is the medical condition caused by envenomation by one of several species of the Loxosceles genus of spider; the brown recluse spider. Envenomations most commonly occur in the warm months of late spring to early fall. The bite is initially painless and then develops into a painful single dark purple/slowly necrotizing lesion. While some brown recluse spider envenomations result in only the necrotic lesion, some patients can develop a rapid, massive hemolytic anemia leading to profound cardiovascular collapse and death without aggressive medical therapies. Close monitoring for the development of rapid hemolysis is needed and immediate medical treatment with rapid large-volume blood transfusions are required for a patient suspected of the fulminant hemolysis pathognomonic of systemic loxoscelism. Patients suspected of systemic loxoscelism from a Brown Recluse spider bite (BRSB) should be immediately referred to a facility capable of frequent monitoring/transfusions until stable and reported to the state Poison Control Center for urgent discussion with a medical toxicologist. (Tennessee Poison Control Center: 1-800-222-1222).
Loxoscelism Guideline Team:
Rebecca Bruccoleri MD, Medical Toxicology
Saralyn Williams MD, Medical Toxicology
Barron Frazier MD, Emergency Medicine
Kristina Betters MD, Pediatric Critical Care Medicine
Gregory Plemons MD, Pediatric Medicine
Daniel Barrett APRN DNP, Primary Care/Acute Care Pediatric Nurse Practitioner