Table Of Contents
Black Widow bite
- Treatment:
- Intravenous calcium gluconate (10%), narcotic analgesics, muscle relaxants, and benzodiazepines
- Antiserum = for very young or old
Brown Recluse bite
- Treatment:
- Supportive debridement and topical ABX
- Cleansing the bite site,
- rest, avoidance of exercise
- Application of cool compresses, avoid warm compresses
- Antibiotics to reduce secondary infection at the wound site
- Acute phase:
- +dexamethasone
- Loxosceles antivenoms
- have been developed and are frequently used in South America, there is little evidence to support their effectiveness
- Hyperbaric oxygen, dapsone intralesional and systemic corticosteroids, colchicine, and diphenhydramine.
- Necrotic wounds heal slowly, may require surgical excision and reconstruction to close the resulting defect.
- Surgical interventions should be delayed until the wound has stabilized.
- Supportive debridement and topical ABX
Scabies
- Treatment:
- Isolate bedding and clothes for 14 days >> heat treat
- Topical treatment – permethrin 5%
- Applied from the neck down, covering all surfaces of the skin including skin folds, under nails, between buttocks, belly button, toe creases, etc. Leave on overnight
- Repeat treatment in 7 days
- Oral treatment – Ivermectin
- dosage of 200 µg/kg given twice 1 week apart.
- Off label but commonly used
- Prevention:
- Family members / close contacts should be treated at the same time
- Wash all bedding, pillows, worn clothing, etc in hot water and dry on high heat, the morning after tx