@article{ref1,
title="Complications and Outcomes of Brown Recluse Spider Bites in Children",
journal="Clinical pediatrics",
year="2011",
author="Hubbard, Jonathan J. and James, Laura P.",
volume="50",
number="3",
pages="252-258",
abstract="Brown recluse spider bites may cause severe local and systemic morbidity, but data regarding morbidity in children are limited. This study reviewed inpatient medical records (n = 26; 10 years) with a discharge diagnosis of &quot;spider bite&quot; from a tertiary pediatric hospital. The majority (85%) of children had an inflammatory response accompanying necrosis, usually with signs of secondary cellulitis (77%). Hemolytic anemia (50%), rhabdomyolysis (27%), and acute renal failure (12%) were the most prevalent systemic effects. Hemolytic anemia was bimodal in distribution relative to the time-of-onset of the bite (early, 2.2 ± 0.4; late, 6.9 ± 1.5 days postbite, respectively; P = .004). Although no fatalities occurred in the population, 65% of children had major morbidity, including wound complications requiring surgical care and acute orbital compartment syndrome. The findings emphasize the importance of anticipatory patient/family education for outpatients and careful monitoring for systemic morbidity in inpatients. Timely and appropriate supportive care should yield favorable outcomes in most cases.<p />",
language="",
issn="0009-9228",
doi="10.1177/0009922810388510",
url="http://dx.doi.org/10.1177/0009922810388510"
}