1. Is it a spider bite or an infection? Brian M. Bourgeois, M.D., F.A.C.S. Westbank Industrial Medicine

2. Cellulitis  Infection of the skin and its appendages  Progresses through the layers of skin  Involves transgression of epidermis by external source  Introduction of native or foreign bacteria

3. Cellulitis  Recognition  Treatment  Antibiotics – first line vs. second line  Surgical drainage  Outpatient vs. inpatient

4. Pathogens aka. offenders  Staph.  Strep.  Vibrio  Tetanus  MRSA

5. MRSA  Methicillin resistant Staph. Aureus  Appropriate treatment  Carrier state  Prevention  Damage control

6. Spider Bite  Brown recluse  Frequency  Recognition  Treatment  Prevention

7. Brown Recluse

8. What’s the Hubbub?  Necrosis  Secondary infection  Tissue loss  Outcome

15. Skin Care/Barrier Protection  Mechanical agent  Soaps  Chemicals  Surveillance

16. MYTHS and FACTS  All infectons are due to spider bites  All spider bites cause infections  These infections are resistant to antibiotics  Infections are contagious  Patients require significant operations