TY  - JOUR
PY  - 2011//
TI  - Complications and Outcomes of Brown Recluse Spider Bites in Children
JO  - Clinical pediatrics
A1  - Hubbard, Jonathan J.
A1  - James, Laura P.
SP  - 252
EP  - 258
VL  - 50
IS  - 3
N2  - 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 "spider bite" 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 /> 
LA  - 
SN  - 0009-9228
UR  - http://dx.doi.org/10.1177/0009922810388510
ID  - ref1
ER  -