-Suspected- spider bite !!GRAPHIC!!

[The Snark]

For reference. Causes of wounds are not always obvious, even after months of treatment.
The extremely slow healing caused the doc to suspect a spider bite as the cause. Staph but not MRSA was present and active. Staph and poor diet could also have been the entire cause. Chronic medical conditions such as diabetes, chronic poor blood profusion etc can also contribute to the wound and confusion.
The bottom line is, if the spider hasn't been caught in the act or the evidence of a bite is overwhelming, don't jump to conclusions.

[YOUTUBE]Scqq-hBG2bw[/YOUTUBE]

 

[Malhavoc's]

Have to admit, after lingering on these boards for the past few years, the amount of doctor stories I hear that " rush to blame a spider" had me a bit, dubious of our medical professionals, This doc seemed rather cautious to say it was a spider at all, even when the patient presented evidence of it " if had a hole" on the follow up video.

Long story short, Glad to see a test for staph rather then just pointing fingers.

 

[The Snark]

I've been chatting it up with a pro dermatologist lately and have been given a few revelations. Nice to have a doc that doesn't treat us non lettered as imbeciles. He pointed me to that video.

Anyway, the jist is the dermal layers do not always attempt to eject matter but often encyst it and harbor both the origin trauma and secondaries. So you get a lesion of something other, the skin will encapsulate, or attempt to. This can produce those non healing wounds. From that many professionals will jump to the conclusion of a necrotizing venom when it is in fact multiple infections and the dermal layers un-healing methods keeping the wound going and even expanding.
In the case of the wound in the video both normal staph and later MRSA were involved. It took almost 6 months of continuous debridements and various anti infection treatments to get the wound to properly heal. There never was any evidence found of a necrotic agent.

 

[Goldcup]

"Spider bites"

I am a newer than a newb to tarantulas.
But I have owned a pest control company for 20plus years. We have had hundreds of cases
Of customers reporting that a dr has identified a spider bite and so their homes must be "infested"
Upon inspection no evidence is found of any spider activity! From my experience and what I know of common spiders I would expect that the actual incidence of spider bite is quite low(statistically irrelevant)
I think Many times medical staff are at a loss to explain so they blame spiders.
There is reason to be hopeful as now the pest that Doctors like to blame is bedbugs!

 

[Malhavoc's]

I am a newer than a newb to tarantulas.
But I have owned a pest control company for 20plus years. We have had hundreds of cases
Of customers reporting that a dr has identified a spider bite and so their homes must be "infested"
Upon inspection no evidence is found of any spider activity! From my experience and what I know of common spiders I would expect that the actual incidence of spider bite is quite low(statistically irrelevant)
I think Many times medical staff are at a loss to explain so they blame spiders.
There is reason to be hopeful as now the pest that Doctors like to blame is bedbugs!

Had a friend from So cal skype call me due to the invasive invasion of the Brown recluse, having finally captured a semi identifiable corpse for him to present to me to prove that they had indeed come with small arms fire and ballistic cover to take him away, Turned out it was just a local adult male trapdoor. Then when pointing out the differences to him from a Recluse and a trapdoor his reply was " but you see how they look the same right?" I guess, if I was arachnophobic? people confuse me.

I've been chatting it up with a pro dermatologist lately and have been given a few revelations. Nice to have a doc that doesn't treat us non lettered as imbeciles. He pointed me to that video.

Anyway, the jist is the dermal layers do not always attempt to eject matter but often encyst it and harbor both the origin trauma and secondaries. So you get a lesion of something other, the skin will encapsulate, or attempt to. This can produce those non healing wounds. From that many professionals will jump to the conclusion of a necrotizing venom when it is in fact multiple infections and the dermal layers un-healing methods keeping the wound going and even expanding.
In the case of the wound in the video both normal staph and later MRSA were involved. It took almost 6 months of continuous debridements and various anti infection treatments to get the wound to properly heal. There never was any evidence found of a necrotic agent.

Le Question (its a fancy french question)

Why would the skin encapsulate rather then eject?

 

[The Snark]

(snip) Then when pointing out the differences to him from a Recluse and a trapdoor his reply was " but you see how they look the same right?" I guess, if I was arachnophobic? people confuse me.
Le Question (its a fancy french question) Why would the skin encapsulate rather then eject?

People are confusing. A grand mass of paradoxes and alternative realities.

Went into a very long discussion about encapsulate. I'm going to dumb this down to avoid hours of digging through medical texts for the correct wording and nomenclature.
The skin, dermis, isn't a single organ with a single purpose. It is also not a single body function but several dozen. A protective covering, a source of nutrients, a sense organ, a thermal regulator, a small galaxy of chemical processes and so forth. Essentially, about 2 years of book cracking if you want your specialty to be dermatology.

Dumb it down. Metabolically speaking, the dermal layers not only regenerate, they constantly replace themselves. They use more nutrients than any other organ. The body expects the outer layers to be damaged and destroyed and become ineffective in defense of the body. So enter the circulatory and one aspect of the neurological systems in building and replacing dermal cells.

This cell replacement is the epitome of mass production: slam new cells in there pronto. Let the cells built in genetic instructions sort it out. But, and by itself pretty inaccurate, the cell building process is not very well organized. Think of a few trillion workmen on the job site instructing their replacements how to hammer nails and pour concrete. The general plan is followed but there will always be individual variations. A quick glance at your own skin will show you hundreds of minor variations.

So to simplify the answer, the cells are simply incapable of working in concert to rid themselves of a foreign object. To them, the foreign object is just a normal part of the landscape to be worked with or around. They build around it, encapsulate it, attach it to their replacements and so on. It is an entirely different bodily function, the immune system, to identify and remove a foreign object. In turn, the immune system has a limited learning ability but cannot properly identify and cope with every foreign object that it comes across. It also has no control over other cells, like the dermal layers, in telling them how to do their job.

The cell replacement of the dermal layers often causes problem and is far from perfect. As example a burn. The instructions handed down to the future generation of workmen is scrambled and damaged. Thus scar tissue is formed. One of the major problems with this ongoing construction effort is the body may not be able to relate to and provide support services. Poor vascularization and subject to infection an obvious problem.

The healing process of the skin must sometimes be prohibited or restricted. As example, closing up a wound that needs to be constantly drained or regrowth inhibited so a transplant of healthy properly instructed cells can be installed. Or encapsulating undesirable cells, foreign material or organisms in the rush to accomplish the primary function of keeping the body covered in a protective layer.


Is this confusing enough? There is plenty more.

 

[Malhavoc's]

Thank you for the info Snark and dumbing it down for me!

 

[nurunuru]

People can get very put out if you try to take away their 'I got necrosis from a brown recluse' badge of honour - no matter how erroneous it may appear.

A co-worker's wife claimed to have been bitten by a brown recluse - in freakin' Minnesota :roflmao: - so I attempted to enlighten her to the fact that it was nigh-on impossible that she had actually been bitten by a recluse, and she had in fact been misdiagnosed. She actually took offense at this attempted elucidation, and would not budge an inch. Evidently, in her mind - despite only a single brown recluse ever having been found in the wild in MN (way back in 1953) - there had been at least one more, and it had bitten her on her porch. Even though she never saw it. Uh huh. Naturally, this exasperated me... but, much like a real-life brown recluse... I left her alone.

Maybe it's the fact that these ridiculous diagnoses are coming from medical professionals that people cling to the lie.

Maybe it's because it sounds cooler than just getting a lame old infection.

Maybe people just want to hate on spiders.

Maybe most people are just thick as two short planks.

 

[The Snark]

Transcribed from my convo with the doc: "The incipient cause only becomes relevant during the therapeutic phase of the treatment if it is obviously interfering with the treatment. Your paramedic kit consists mostly of what? Dressings. You keep the wound as clean as possible. You bring the patient to the ER, what is the first thing you do? Clean the wound. So, be it an infected pore or hair follicle or puncture wound of insect - spider bite, the real and present danger is infection. Around 99% of these wounds involve staph. So when the patient or medical staff gets to talking about spider bite they are looking at a single apple but missing the tree it came from. A minuscule aspect in a much larger picture."

Me: "Red light fever. Tunnel vision."

Doc. "Exactly. In part. Some ER staff may speculate as to the the cause, and most patients do, but in the case of an angry infection which is the main reason a patient seeks medical help, that cause is a secondary minor issue. Take a gun shot wound. The patient thinks about the bullet, remove the bullet, right? They aren't thinking about the trauma, the massive tissue damage. The bullet can go hang. Repair the damage and give the body a chance to do it's repairing job while minimizing the real and present danger of infections."

 

[pitbulllady]

I've been chatting it up with a pro dermatologist lately and have been given a few revelations. Nice to have a doc that doesn't treat us non lettered as imbeciles. He pointed me to that video.

Anyway, the jist is the dermal layers do not always attempt to eject matter but often encyst it and harbor both the origin trauma and secondaries. So you get a lesion of something other, the skin will encapsulate, or attempt to. This can produce those non healing wounds. From that many professionals will jump to the conclusion of a necrotizing venom when it is in fact multiple infections and the dermal layers un-healing methods keeping the wound going and even expanding.
In the case of the wound in the video both normal staph and later MRSA were involved. It took almost 6 months of continuous debridements and various anti infection treatments to get the wound to properly heal. There never was any evidence found of a necrotic agent.

Second that! It is disturbing to think of how many people suffer unnecessarily and undergo painful, and again, unnecessary, medical procedures for "spider bites" that are really something else entirely, thanks to a doctor's tendency to jump to conclusions. I had a large, painful lesion on my leg several years ago, and my doctor at the time was convinced it was a spider bite. I was skeptical of that diagnosis, so he referred me to a colleague, who also said that it was a "Brown Recluse bite"(I was living in the coastal/Pee Dee region of South Carolina) and that the only way to "stop the poison from spreading further" was to operate and cut out a big chunk of my leg muscle and then perform skin grafts to cover to wound. Fortunately, there was another doctor at that practice, from India, who was a specialist in animal envenomations, and he disagreed with his partner's assessment of a spider bite. I was put on a strong antibiotic, and refused to let the surgeon touch me. A couple of days later, I was able to discern some sort of dark foreign material in the wound, and it turned out to be an ingrown hair. REALLY ingrown. As in over three inches long upon removal. Once it was removed via some self-"surgery", the wound cleared right up. I don't even have a scar there now, but had I listened to the first two doctors, I'd have one helluva scar as "proof" of what a "spider" can do.

 

[The Snark]

PBL, you reminded me of a comedy I once had. Many similarities.

I had a bump under the skin on my throat as long as I can remember. Called a technical name I forget for a chronic cyst. It would come and go, sometimes missing for months or even years. I had been told if I wanted it removed it would require taking a good chunk of all dermal layers as well. So I ignored it. I'm not into voluntarily having my throat cut.

One day I was chatting with a friend, a doc who was retiring, and he was staring at my throat. "Let me look at that." He got out magnifying glasses and fussed, finally telling me to meet him in the ER the next day. When I did he jumped me like I was a patient, getting me on a gurney and going to town with a serious examination. About 100 painful squeezings later he holds up an object and asks, "How about this?" A huge weird glop thing. A colleague of his strolls over and looks at it, examines me, then asks if I'm Indian. He BTW was from India. They do a little gross dissection of the thing under magnifying glasses. Several other docs stroll by checking it out and making ribald comments. Between 20 and maybe 50 hairs growing out of one follicle. When they broke the skin I shaved them off. It was explained to me it was a genetic trait Mongols sometimes have that carried over to natives in America. My doc friend gave the location a quick stab with the electrocautery knife, killing the follicle and that was the end of that.

Doctors are a lot more fun when they go into mad scientist mode.