TY - JOUR
T1 - Necrotic arachnidism and intractable pain from recluse spider bites treated with lumbar sympathetic block
T2 - A case report and review of literature
AU - Yi, Xiaobin
AU - Aubuchon, Jacob
AU - Zeltwanger, Shawn
AU - Kirby, John P.
N1 - Funding Information:
Supported by none.
PY - 2011/6
Y1 - 2011/6
N2 - Brown recluse (Loxosceles reclusa) spider bites mainly occur in the southern and Midwestern United States. The clinical manifestation of brown recluse spider bites varies from skin irritation, a small area of tissue damage to neuropathic pain, necrotic arachnidism and severe systemic reactions such as acute renal failure and even death. Treatment is controversial and nonspecific. We describe a case of extensive right lower extremity tissue necrosis and intractable neuropathic pain treated with lumbar sympathetic block in a patient with a documented brown recluse spider bite. Both his pain and tissue necrosis improved significantly with lumbar sympathetic block with local anesthetic. After a series of lumbar sympathetic blocks, his symptoms resolved and lower extremity wound healed rapidly. We discuss the benefit of sympathetic blockade not only for neuropathic pain but also possibly as a treatment for necrotic arachnidism from a brown recluse spider bite.
AB - Brown recluse (Loxosceles reclusa) spider bites mainly occur in the southern and Midwestern United States. The clinical manifestation of brown recluse spider bites varies from skin irritation, a small area of tissue damage to neuropathic pain, necrotic arachnidism and severe systemic reactions such as acute renal failure and even death. Treatment is controversial and nonspecific. We describe a case of extensive right lower extremity tissue necrosis and intractable neuropathic pain treated with lumbar sympathetic block in a patient with a documented brown recluse spider bite. Both his pain and tissue necrosis improved significantly with lumbar sympathetic block with local anesthetic. After a series of lumbar sympathetic blocks, his symptoms resolved and lower extremity wound healed rapidly. We discuss the benefit of sympathetic blockade not only for neuropathic pain but also possibly as a treatment for necrotic arachnidism from a brown recluse spider bite.
KW - Necrotic arachnidism
KW - lumbar sympathetic block
KW - neuropathic pain
KW - recluse spider bites
UR - http://www.scopus.com/inward/record.url?scp=79955826303&partnerID=8YFLogxK
U2 - 10.1097/AJP.0b013e31820b6424
DO - 10.1097/AJP.0b013e31820b6424
M3 - Article
C2 - 21317774
AN - SCOPUS:79955826303
SN - 0749-8047
VL - 27
SP - 457
EP - 460
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
IS - 5
ER -