Convenient culprit: Myths surround the brown recluse spider

The reputation of the shy, retiring Loxosceles reclusa far exceeds the spider's range, confusing efforts to diagnose or accurately track the true incidence of its bite.

By Nina Sandlin, AMNews staff. Aug. 5, 2002.

Last fall, when a 7-month-old child, admitted to a New York hospital with a swollen arm and a runny sore, developed hemolytic anemia, the working diagnosis was brown recluse spider bite.

But days later, cutaneous anthrax was reported at media offices in the city, and the baby, who had visited the ABC News studio with his mother, tested positive for the bacilli. The infant's severe systemic symptoms were atypical for anthrax, a disease all but unheard of in U.S. population centers for decades.

It was, in other words, an interesting case, and one that drew significant attention in light of the national emergency -- the country's youngest anthrax victim. But in other respects, the case was commonplace.

More than 2,000 brown recluse bites are reported to poison control centers each year. And, if epidemiology and confirmed cases are any indication, most of them are something else.

"Doctors are horrible [about] misdiagnosing any kind of necrotic-looking wounds as brown recluse bites," says Sean P. Bush, MD, a professor of emergency medicine at Loma Linda School of Medicine. An envenomation specialist, he has become the "go-to doctor" in Southern California for suspected spider bites.

In the emergency department "you see a necrotic wound every other shift," he says, but spider bites are a rarity. Even with black widows, which "are totally ubiquitous here," he only sees about half a dozen bites a year. "If it's an 'exciting year,' maybe 10."

And Dr. Bush doesn't see any brown recluse bites. [...]