posted
At least I think it's a bug bite. I have a red place on my arm. There's an itty bitty head to it, which I think is the bite, but the skin around it (about the size of a quarter) has welted up and is red. There is also a pale red streak coming out of the welted area and going up my arm. I took some benedryl last night. It's not getting worse, but it's not any better.
posted
I don't like the sound of that red line extending from the welt, Space Opera. That's generally not the sign of a wound that's healing properly. Maybe Sara or Theca would tell you differently, but just the red line would be enough for me to have a doctor look at it.
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posted
How far away from the bite does the line go?
If it was me, I'd probably call my doctor's office, since (as far as I know) discolored lines extending from a wound can be a sign of blood or lymphatic poisoning.
[I once had one of those little discolored lines (about 6 inches long) going away from a wound on my heel (after having a plantar wart removed). My doctor told me to monitor it and that if it grew rapidly, I needed to come in and be seen. It went away after a couple days.]
posted
Space Opera, red streaks should be looked at by a professional, definitely. It's concerning for inflammation/infection of the veins or lymph vessels. [er, what ludosti said. And Noemon. ]
Please do see someone, or at least call.
On a related note, do you have a heart murmer or any implanted parts?
[ September 13, 2004, 03:21 PM: Message edited by: Sara Sasse ]
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posted
If you had called me professionally for advice, I wouldn't be comfortable unless a nurse or somebody with proper training eyeballed it and made a provisional plan with you.
Pediatric emedicine article on lymphangitis. It is geared toward kids, but I would do the same for a teenager or (I would suspect) an adult.
quote: Physical: -Clinically, erythematous and irregular linear streaks extend from the primary infection site toward draining regional nodes. These streaks may be tender and warm. The primary site may be an abscess, an infected wound, or an area of cellulitis. -Lymph nodes associated with the infected lymphatic channels often are swollen and tender. -Children may be febrile and tachycardic. [this would be more likely to be true for young kids as vs older kids or adults]
Causes: -In individuals with normal host defenses, group A beta-hemolytic streptococcal (GABHS) species are the most common causes of lymphangitis. ... -Lymphangitis caused by GABHS can progress rapidly and has been associated with serious complications. -Other organisms include Staphylococcus aureus and Pseudomonas species. ... -Any child who presents with lymphangitis should have a CBC, blood culture, and aspiration. -CBC and differential often reveal marked leukocytosis. -Blood culture may reveal that infection has spread to the bloodstream; however, blood culture results rarely are positive.
Aspiration: -Culture and Gram stain of the primary site of infection may help identify the infectious organism and help choose antimicrobials. -Some authors recommend aspiration of the leading edge of infection; others prefer sampling the area of maximum inflammation. ... Procedures: -Abscessed areas may require incision and drainage. -Culture and Gram stain of fluid may help identify the causative organism and help select antimicrobials. ... Treatment: -Treat children with lymphangitis with an appropriate antimicrobial agent. -Children in stable social situations who appear nontoxemic and who are older than 3 years, afebrile, and well hydrated may be treated initially with PO antibiotics on an outpatient basis. Ensure close follow-up. -Parenteral antibiotics may be required for a patient with signs of systemic illness (eg, fever, chills and myalgia, lymphangitis). -Aggressively treat suspected cases of GABHS; these cases can progress rapidly and have been associated with serious complications. -Analgesics can be used to control pain, and anti-inflammatory medications can help reduce inflammation and swelling. Hot, moist compresses also help reduce inflammation and pain.
Someone should at least examine it even if they don't do bloodwork, I should think.
[ September 13, 2004, 03:35 PM: Message edited by: Sara Sasse ]
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quote:Spider bite is a subject of much medical mythology with prevalent fears that spiders cause severe envenoming, with neurotoxic effects or necrotic ulcers. [In clinical studies of] 750 people with definite spider bites where the spiders were immediately collected and expertly identified...significant effects occurred in 44 bites (6%), including 37 (of 56) redback spider bites (Latrodectus hasselti) with significant pain lasting >24 h. Of these, only 6 (11%) received antivenom. One severe neurotoxic envenoming by an Australian funnelweb spider required antivenom. No definite spider bites resulted in necrotic ulcers...There were no early allergic reactions and secondary infection occurred in seven cases [out of 750 or 0.9% or 9/1000]...Australian spider bite caused minor effects in most cases and is unlikely to cause necrotic ulcers, allergic reactions or infection.
In news followups, the authors of the study stated that the data strongly suggests that blaming such severe effects on spider bites is usually a misdiagnosis. When they interviewed people who had necrotic ulcers, alergic reactions, and infections blamed on spider/insect bites, it turned out that very few patients had any memory of having been bitten in the region affected, and that it was the doctors who assumed that there had been a spider/insect bite. They also suggested that the "spider venom" misdiagnosis led to insufficient aggressiveness in treatment of the real problem, infection.
In the US, the fact that such severe effects are often blamed on eg the brown recluse spider -- even in regions in which there are no brown recluse spiders; even though brown recluse spiders are so non-aggressive that "a family...collected more than 2,055 brown recluse spiders in their home over a period of six months. Spiders were found on the paper towel rack, crawling up stairs and hidden among piles of laundry. However, in the six years the family lived inside the infested home, no one was ever bitten"; and even though redness and swelling is often blamed on spider bites when it is known that eg jails harbor infectious agents which cause those symptoms -- makes it quite probable that the same problem of misdiagnosis due to medical myth occurs in the US as it does in Australia.
A noticible line or an odd shape on the skin extending from a circular reddened area can mean that bacteria are colonizing a near-surface blood vessel, or a virus infection is following a near-surface nerve. Could be a staph infection, or Lyme disease, or... So don't let the docs blow off an oddness in the redness&swelling as just a spider/insect bite.
posted
I came close to losing my cousin to an infection - go get it looked at!
Ant bites I know from personal experience have the red swelling with a distinctive white head in the middle, but I've never had an ant bite do what you're describing. It may be an insect bite, it may not, but heed what Sara says and get it eyeballed by a professional! Please!
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posted
What did the Dr. say, Space Opera? I'm assuming that you've had it checked out by now. If you haven't, is there any change in the wound? Does the red line extend further, for instance?
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posted
I can't imagine that a physician would blow off red streaking from a wound back toward the heart as "just a spider bite" -- that would be silly. The finding is essentially pathognomonic for some type of vessel inflamation [which, of course, could occur secondarily to a spider bite, but it would still be a distinct phenomenon in itself].
I'm not so sure that you can extrapolate from Australian data to the US population: different demographics, different epidemiology (their medical literature seems to be rife with discussion about spider bites, while ours is scanty by contrast, likely reflecting a difference in incidence as well as interest).
We also know that somewhere around 1/3 to 1/2 of patients with confirmed Lyme disease do not recall a tick bite, despite the fact that one must have been attached to the skin for a minimum of 24-48h to provide a vector for the Borrelia spirochetes. People just can't always identify or remember small bites. Still, though, your point about possible misdiagnosis is well-taken, though I'm not sure it would affect the treatment.
Brown recluse spider bites might be overdiagnosed (I honestly don't know), but the progression of a true brown recluse bite is pretty diagnostic. Erythema, clear vesicle, then necrotic spread with a dark eschar -- it just looks different. The center flesh liquifies.
[ September 14, 2004, 03:41 PM: Message edited by: Sara Sasse ]
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posted
Actually, it sounds more like a sting. Wasp/bee/ant venom will cause a red swelling, and sometimes streaks of red. If the swelling continues, by all means see a doctor! You don't want to find out you are deadly allergic to something by going into anaphylaxic (sp?) shock.
I have experienced similar symptoms to a wasp sting, but a judicious application of baking soda within 5 minutes immediately neutralized the venom and the swelling disappeared. Of course, the pathogen was known, and I am not terribly allergic to stings.
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posted
Thanks to everyone for the advice. I actually didn't go to the dr. because I've spent most of the day in a benedryl-induced coma. However, the swelling is slowly going down and the red is beginning to fade to a pink. So unless it gets worse I'll just continue to take benedryl. Thanks again!
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