Necrotic arachnidism and intractable pain from recluse spider bites treated with lumbar sympathetic block: A case report and review of literature

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Abstract

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.

Original languageEnglish
Pages (from-to)457-460
Number of pages4
JournalClinical Journal of Pain
Volume27
Issue number5
DOIs
StatePublished - Jun 2011

Keywords

  • Necrotic arachnidism
  • lumbar sympathetic block
  • neuropathic pain
  • recluse spider bites

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