Toxicology

Question 1

What symptoms are seen in the first 12 hours of a brown recluse bite?

Answer 1

itching, pain, swelling, erythema

Question 2

What symptoms do you see 24-96 hours after a brown recluse bite

Answer 2

ecchymosis, serous/hemorrhagic blisters/bullae
fever, myalgias, arthralgias, vomiting, rash (erythroderma, pustular)
hemolysis (avg day 4)

Question 3

What symptoms do you expect after 96 hours after a brown recluse bite?

Answer 3

+/-necrosis

Question 4

What systemic changes do you see for systemic loxoscelism?

Answer 4

thrombocytopenia, DIC, ARF, acute liver injury

Question 5

when do you get labs for brown recluse bites?

Answer 5

When they have systemic symptoms
preverbal children or any question about dx

Question 6

What labs should you get for a brown recluse bite ?

Answer 6

cbc, bmp, lfts, coags, +/- bld cx, UA