Spider Bites
                                ============

þ Widow Spider Bites
 - Antivenin (Lyovac)
  + may be useful up to 30 hours after a bite [Suntorntham S, Roberts JR,
    Nilsen GJ.  Dramatic clinical response to delayed administration of black
    widow spider antivenin.  Ann Emerg Med 1994;24(6):1198-9.]

þ Recluse Spider Bites
 - Not found N. of I-80 in the NW
 - Pyoderma gangrenosum may be a complication of recluse bites.
 - Dapsone vs. HBO once you see necrosis
 - One study shows that most things we think are necrotic spider bites aren't.
   Study of 600 suspected spider bites.  Found 80% caused by other arthropods,
   and 10% from other disease states.
   [Russell FE, Gertsch WJ. For those who treat spider or suspected spider
   bites. Toxicon. 1983;21:337-339.]
 - Dapsone:
  + also used for pneumocystis in AIDS <ID-Aids.TXT>, leprosy, and dermatitis
    herpetiformis
  + unsafe for use in Porphyria <M-unsafe.TXT>
  + dapsone may cause methemoglobinemia <P-methem.TXT>

þ Tegenaria Agrestis (hobo spider, common aggressive house spider)
 - found mostly in Pacific NW
 - can have necrosis just like brown recluse bites, but these spider
   bites can be found further north than brown recluse.
 - Anecdotal reports (Jim Blackman, M.D., Boise, ID) of success with Dapsone
   in these bites (one bite got worse after Dapsone stopped then got better
   when restarted).