Pediatric emergency medicine trisk 1808 1808

Antibiotics are indicated if there are signs of secondary infection. Some authors
recommend corticosteroids if the patient presents within 12 hours of a bite but the
efficacy of this approach is unproven. An antivenom exists if there are systemic
signs.

FIGURE 88.4 Spider recluse.

It is important to point out that spider bites are often blamed for solitary or
several skin lesions. There is a literature that suggests spiders are unfairly
maligned in this regard, and that misdiagnosis is extremely common. Especially
in areas where the brown recluse spider is rare or totally absent, it is important to
consider mimics such as Staphylococcus aureus abscess, herpes zoster, and
Sporothrix schenckii infections, to name a few.

Scabies Infestation
Please see Chapter 67 Rash: Vesiculobullous for more details. The cardinal
symptom of any infestation with scabies is pruritus. Two clues should be
considered when attempting to make this diagnosis: (i) Distribution (small red
papules with concentration on the hands, feet, and folds of the body, especially
the finger webs and genital areas) and (ii) involvement of other family members.
It is important not only to ask other family members if they have pruritus but also