S104 – Treatment of a Brown Recluse Spider Bite to the Face

Abstract

Objectives 1) To raise awareness among otolaryngologists about the presentation, complications, and treatment options of brown recluse spider bites. 2) To present a case of a brown recluse spider bite to the face that was treated conservatively and had an excellent aesthetic result. Methods A 48-year-old woman was referred to the otolaryngology clinic with a dermonecrotic wound on the left upper lip from a brown recluse spider bite. The lesion consisted of a 4mm eschar with surrounding erythema, and the necrosis extended almost through the lip, sparing only the oral mucosa. She was given antibiotics and followed clinically. The eschar was left in place without debridement or topical treatments, and it fell off on day 40. Results After the eschar fell off on its own, the patient was left with complete healing of the necrotic area and a 1mm scar with mild erythema, giving her an excellent aesthetic result. Conclusions This case represents conservative management of a self-limited dermonecrotic lesion of the upper lip that resulted from a brown recluse spider bite. Conservative management should be considered with brown recluse spider bites, especially on the face, which has an excellent blood supply and where good aesthetic outcome is crucial.