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Muñoz Family Health Clinic
Health Matters Summer 2006

Spider Bites or Boils.

Skin infections which are commonly mistaken for spider bites are on the rise in the United States. Persons usually develop small lesion which looks like a pimple and within days it becomes large, painful, and swollen. In the early stages of infection many people tend to neglect these abscesses and will present for medical care when they notice worsening. The lesions can present as one isolated boil or a cluster of boils which can affect different body parts. These infections are important to recognize and treat early, as they can lead to severe infections of blood and soft tissue which require long term I.V. antibiotics. There have even been documented cases of disability and death from such infections.

Methicilline Resistance Resistant Staph Aureus (MRSA) is usually the bacteria found in these abscesses. Although MRSA used to be exclusively associated with infections acquired in the hospital or health care setting(healthcare associated MRSA or HA-MRSA), a new community epidemic strain has come into existence (community acquired MRSA or CA-MRSA). Literature states the people at risk of developing these infections include: sports participants, inmates, military trainees, children in day care centers, Native Americans, Alaska Natives and Pacific Islanders, men who have sex with men, tattoo recipients, individuals living in a rural population with a high prevalence of crystal methamphetamine use, and, more recently, hurricane evacuees in shelters (Gorwitz.). Interestingly though, many patients who present with CA-MRSA infections to primary care clinics, do not have any of the above risks.

CA-MRSA can be difficult to treat and will often require draining of the wound and multiple antibiotics. CA-MRSA and HA-MRSA respond to antibiotics differently, they progress differently, and usually affect different populations. HA-MRSA often is acquired during a hospital (health care facility) admission. It is aggressive and can be fatal if not treated early. It often requires IV antibiotics for treatment. It can infect organs, joints, the blood stream and may become a chronic infection in some people, requiring antibiotics for long periods, perhaps a lifetime.

CA-MRSA infections can also progress to the blood stream and cause death if not treated early. It usually responds to oral antibiotics, is treated by draining of the abscess and most patients do not require hospitalization or IV antibiotics. In summary, if you happen to notice a lesion such as the ones described above, be sure to go to your Primary Care Physician in the early stages and have it evaluated.