I need help telling a toxic spider (probably brown recluse) bite from lyme disease.
I first noticed bite on Thursday, April 17. It was about two inches above the sock line, on my shin. There was a large bite mark in the center that must have bled rather copiously. Blood hadn't run down my leg, but I first noticed the large, thick, clotted dark scab. It appeared to be a fresh wound, and not days old, but old enough for the clot to be completely dried. However, if the wound had been breaking down for days, it is conceivable that the bleeding had just happened.
Around it was a small red, possibly pitted area (don't remember), then a grey-white ring. Around that was a rash, with red streaks extending outward from the bite mark to the edge of the rash. The streaks formed an odd pattern, with strange, sometimes right angles, and some of them intersected. Most of them extended to the side or upwards, up the leg. They didn't really extend downward toward my foot. The entire affected area was about an inch and a half across, oval in shape; and except for changes in the swelling, the size of the entire affected area never changed. The rash may have been a bit worse on Friday, when the swelling was also at its worst. On Thurday, when I first noticed it, it was slightly swollen.
Someone at the poison control center tended to agree with my guess that a spider bit a large blood vessel or superficial vein, and the venom followed a pattern of such blood vessels in my skin upward, in the direction in which veins go. The bleeding may have removed some of the venom. I ended up with a small lesion with systemic symptoms, which is consistent with much of the venom got into a vein.
It occasionally burned but did not hurt. To the touch, however, it was acutely painful and very sore, out of proportion to the apparent wound, in the way that an abscess might be.
I had just come home from doing the laundry, and nothing including a tick had much opportunity to bite me. I walked my bike with the laundry to the laundromat. Two hours before I noticed the bite, I had changed into an ankle length skirt that I picked up off of the floor by the closet. That morning, I put on overalls, that had also been on the floor by the closet. I spent the day working inside, in a file room, doing filing, and rode my bicycle to work, and home. I never noticed that anything bit me.
Sicne I had no idea what had bitten me, I washed and disinfected the wound thoroughly. I applied meat tenderizer (with papain) for several hours, and the swelling vanished. Otherwise the wound didn't change. It appeared to be going to do nothing dramatic that night, so I washed it, put on neosporin cream and a gauze pad, and went to bed.
Next morning (Friday), the area was more than a bit swollen, and warm to the touch. I couldn't reach my doctor. I put meat tenderizer on it for the rest of the day, and the swelling vanished again.
Friday afternoon I rather suddenly got a migraine type headache, with sensitivity to light and sound, upset stomach, diarreah, roaring ears, visual disturbances, severe mood disturbance, brain fog, and trouble with memory. I have Menieres' disease, an inner ear disorder that can cause most of this, but it had been perfectly quiet for two months. I did not have much hearing loss, which usually accompanies a menieres' flare. I also did not have alot of dizziness. I get migraines, but again not usually suddenly and without any trigger such as my menstrual period, and had not had one in a couple of months.
On Friday afternoon, which was a hot, humid afternoon, my temperature was 99.1, and on Monday morning it was normal.
These symptoms came pretty much every afternoon and evening for the next few days and always appeared together - except for the brain fog and diarrhea, which were more or less constant.
By maybe Sunday afternoon, the wound had formed a thick and tough layer of roughened dead, white skin over the bite mark and the gray-white ring, that for a time obscured the bite mark itself, and that could not be penetrated with a needle. It may have been a blister, but it did not have the raised, fluid filled appearance of a blister, and a blister normally has a thin layer of dead skin that can be easily broken with a needle. Someone wrote me that she had a brown recluse bite that produced a huge area of thick, rough, dead white skin like this. It had exactly the consistency of the charred layer on a third degree burn, of which I have over the years had several. It differed from the descriptions I have read of eschar only by being white instead of black; and there was also no sign of infection that could not be accounted for by spider venom. The charred layer of skin on a third degree burn is a classic example of eschar. I think it was necrotic skin. Supporting that notion is that the gray-white ring of a bulls eye rash is dying skin, and the layer of dead white skin initially exactly covered the region of the gray-white layer and the central bite mark. It would be reasonable to think that if the skin was dying, it ended up dead.
By Monday night, this area of dead skin expanded to twice its size, upward, in the direction of the worst streaks. Originally it was found; it ended up being an elongated oval.
Sunday I collected plantain leaves at my sister's house, and we chopped them finely in a food processor, and I put a plantain leaf poultice on the wound. By Monday morning, the streaks were faded, the rash was about gone, and the wound appeared to be healing. This was deceptive, but Monday morning is when I saw the doctor. I understood that one has to be screened for lyme disease since the symptoms I had are standard for both lyme disease and spider bites.
Doctor said, this is healing, this is not a brown recluse spider bite because I would have a massive wound if it were, no other spider could do that, it has to run its course, and it isn't lyme because lyme disease is rare in Texas, no bulls eye rash (I described to him three times in detail the classic bullseye rash that was not still there), and the rash that was thre was not four inches in diameter. Not two inches (5 cm), but FOUR inches (10 cm), by his book. He refused to do a lyme test. He told me noone ever believes him when he says they can't have lyme disease, so he prescribed a "prophylactic" dose of antibiotic; a single dose of two docyclycline tablets. I did not take this antibiotic; apparently more wisely than I realized. I thought it would simply do no good, if what I had was in fact a fully developed lyme rash, and I had neither the cash, nor the time to spend on the long trip to the drug store. Actually apparently if I had taken the inadequate dose of antibiotic it might have both made a lyme test falsely negative if I eventually get one, and made lyme disease harder to treat if I in fact had it.
I kept the plantain poultice on it for another day. After two days I became convinced it was healing, and took it off. The plantain leaves had stuck to the central wound and dried, and removing them dematerialized the layer of dead skin over the wound, leaving a pit, which remained weepy.
A day later, the swelling was back, the rash was somewhat back, the wound was complaining, sore and painful, and the streaks were not only back bigger than life, but several of them had erupted into lines of little round sores with scabs on them.
I just kept disinfecting it and putting neosporing cream and a clean gauze pad on it.
The wound has been healing slowly and unevenly since. Currently there are scars where the streaks and the sores along the streaks were, and a central scab. Scatching off the scab to see what was under it, a pit that bled copiously; seems to have aggravated it.
Consensus among people more knowledgeable than my doctor is this was a brown recluse spider bite because:
1. Brown recluse spiders are common in Austin and nothing else could have made such a wound without me noticing. A spider in my clothing that I picked up from the floor is a classic brown recluse situation.
2. Lyme rashes aren't painful.
3. Lyme rashes come on slowly and last for longer than a couple of days or a few days.
3a. Systemic lyme systems with a primary infection don't usually fade within a week, and be much better three days later.
4. The bulls eye rash of lyme can be any size and have many appearances, but they never have streaks unless some other superficial infection also exists. I get the idea that for a lyme rash to have streaks that break down into fresh, round sores with scabs would be medical history. It would also be unusual for an infected scratch of some sort. I have had skin boils, for instance, get infected and have red streaks, but this didn't look anything like those streaks.
5. Lyme rashes don't have necrotic skin.
6. Lyme rashes don't ordinarily have large central scabbed sores.
I can see that Mark, the owner of this web site, apparently DID have a lyme rash with such a large central sore. Mark had a positive test for lyme disease and I think he now has advanced lyme disease. The photo on his web site shows no necrotic skin, though conceivably that was once there just as in my case, and the area had scabbed over. However, the rash in his photo does look like a very classic sort of lyme rash; a huge circular area of beet red skin surrounding the central usually a bulls eye. The affected skin was beet red and otherwise didn't show any evidence of necrosis or breaking down, which isn;t like any other large brown recluse bite photos I 've seen. His photo shows a large but clean scab in the center, surrounded by a large circular lyme type rash, covering otherwise healthy looking, unbroken skin.
I have seen alot of lyme rashes with very different appearances; the rash is finely pebbled or speckly like my rash, or it is composed of lines - that run parallel to each other, and pretty much cover irregular areas like designs made of parallel crayon marks.