Spider Bite Myths

An employee reports to his supervisor that he has a swollen, round skin lesion on his knee. It must be a spider bite, right? Not so fast. An increasing body of research has revealed in recent years that spider bites are often misdiagnosed, especially with respect to brown recluse spiders. In Georgia, for example, a recent study concluded that the brown recluse is not a common spider in Georgia, and that its presence was documented in less than 20% of all Georgia counties—31 to be exact–almost all of which are located in the northwestern Piedmont region of the state. Nevertheless, over a five year period, there were 963 reports of brown recluse spider bites in 103 Georgia counties. Similarly, over a six year period in Florida, where the brown recluse spider is even more rare, there were 844 reports of brown recluse bites. Vetter, R. S., N. C. Hinkle and L. M. Ames. 2009. Distribution of the brown recluse spider (Araneae: Sicariidae) in Georgia with a comparison of poison center reports of envenomations. J. Med. Entomol. 46: 15-20.

So if it’s not a spider bite, what else might it be? As it turns out, other studies indicate that a considerable number of supposed spider bites were actually a MRSA infection, thus leading to a misdiagnosis. Vetter, R. S., B. B. Pagac, R. W. Reiland, D. T. Bolesh and D. L. Swanson. 2006. Skin lesions in barracks: consider community-acquired methicillin-resistant Staphylococcus aureus infection instead of spider bites. Military Medicine 171: 830-832. As a result, proper treatment of the infection is delayed, and the recovery period is prolonged. In a workers’ compensation setting, this is obviously bad in several ways: increased exposure for income and medical benefits, as well as potential exposure of the infection to other workers.

In a situation where an employee reports a spider bite, several questions should be asked at the outset: Was a spider ever actually seen? If not, a bite is much less likely. Was the person wearing clothing that covered up the supposed “bite” area? If so, a bite is much less likely. Are there multiple “bite” locations? If so, a bite is much less likely. Also, when sending an employee for medical treatment for a supposed spider bite, always request that a culture be taken to test for MRSA. This is an inexpensive test that can definitively determine whether the lesion is MRSA as opposed to a spider bite, which will expedite the appropriate treatment measures to get the employee healthy and back to work as soon as possible (if it is, indeed, a work-related infection, which is another inquiry altogether). Not only that, but it can also significantly mitigate the enormous potential medical costs associated with treating an advanced case of MRSA, which is a potentially fatal infection if left untreated.

By:  James Smith, Esq.