Spider Bite or MRSA
Sue Hubbard, M.D.
While walking down the hallway in my office, I kept hearing patients expressing concern about a "spider bite." But how many spiders could there be out there, I wondered, especially in early spring? Also, these "spider bites" seemed to occur in weird places -- a baby's bottom, the inner thigh, the palm of the hand. In most cases, a patient never saw the offending spider.
As it turns out, spiders are being maligned when, in fact, they have nothing to do with these random skin lesions. Such "bites" are often due to a MRSA (Methicillin Resistant Staph Aureus) bacterial infection of the skin and soft tissue. With the frequency of such infections rising, parents should be aware of the fact that an unusual "bite" that's becoming more tender, has surrounding redness (erythema), feels warm to the touch and has the appearance of a large pimple or boil, needs to be examined.
In some cases I've seen, a parent has tried to open the lesion with a needle. DO NOT use needles, pins, your fingernails, or anything else to open such sores. As I tell older kids, "If your mom or dad comes at you with a needle, run,
Once a "spider bite" has been correctly diagnosed as a MRSA infection, it's appropriate to try and drain some of the purulent discharge for a culture. Usually, this is easily done in a pediatrician's office. With test results in hand, the correct diagnosis can be made, and an antibiotic can be prescribed to treat community-acquired MRSA.
For larger lesions, it's appropriate to drain them, and this should be done under sterile conditions (no home needles). There are certain times a pediatric surgeon may need to drain these larger lesions.
Numerous journal articles have been published debating the pros and cons of drainage vs. antibiotic use. In most cases in my office, we culture the discharge and prescribe an oral antibiotic. Some articles advocate drainage only, without the use of antibiotics. There is not a definitive opinion on this and I'd defer to your doctor to decide on the appropriate individual treatment.
So ... if you think the spiders have invaded your home, think MRSA instead.
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