Spider Bite? When to send to Dr.?

[Avill, BSN, RN]

Hi all,

I'm a new nurse here at a high school. Had a student come in with a wound on her forehead. Per student she was bitten by a spider 4 days ago and the "swelling had gone down" since the bite. When I examined it it was a small round wound, it had some depth to it and surrounding tissues weren't swollen. She said that she had drained pus out of it right before she came into my office. I put antibiotic cream on it and covered it. Told her to keep it covered and clean and to stop by tomorrow so I can see if it had gotten worse (aka bigger) I'm thinking that if I see signs of infection (I didn't see the pus) and it's getting bigger then I will send her to her Dr or the health clinic we have here.

What would you do? There are such few actual deadly spider bites that I didn't feel the need to send her to her doctor yet.

[zombieghoast]

Unless the area is red, blackened, or has a fever don't worry about it.

[SaltineQueen]

Do you know how many patients I/we used to see at the hospital who came in with a "spider bite" that emwas actually a MRSA infection? Lots. I could have a nice little nest egg built up.

Not just a zit?

Do that many people really get bit by spiders?

[akulahawkRN, ADN, RN, EMT-P]

There are only a couple spiders that actually bite people. Unless the person actually saw the spider bite them, I'd normally consider other causes, such as a S. aureus infection. OP: you're on the right track with having the student (and yourself) watch for signs of infection such as increasing redness, swelling, pus drainage, and fever. There are other insects that do bite and can cause what you saw so do not discount the possibility of fleas, ticks, bedbugs, etc.

[BeckyESRN]

I just sent out a "bee sting" yesterday, mom e-mailed after the appointment-MRSA. The kid had seen bees on the playground and when his finger got a red swollen bump with a little dot in the center, he was sure he'd been stung. He saw me the next day with swelling and redness covering 1/4 of his palm and 2/3 of the dorsal side of his hand!

You advised her to watch for signs of infection. I'd follow-up the next morning and go from there.

[NutmeggeRN, BSN]

Yup, MRSA is the 1st thing that comes to mind. Keep it covered and hopefully treated!

[Avill, BSN, RN]

Thank you all for your input! Yes I did a little research and did take note that it could be MRSA. Let's see what it looks like today. Thanks again all!