Spider Bite or MRSA? (The difference is crucial)

By: Linda Way

A storm is emerging on the general public in the form of antibiotic resistant staph infections. The warning bell is ringing, health care officials know it is a problem, but say it is not the job of the local health department or the CDC to monitor what goes on between a patient and their doctor, Nor is it their duty, obviously, to warn the general population that what you think is a boil or spider bite could in fact be a life-threatening antibiotic resistant form of staph.

HA-MRSA, Hospital Acquired Methicillin Resistant Staphylococcus Aureus, was once only confined to hospital settings, but is now spreading at an alarming rate through the general population in a new form called CA-MRSA, Community Acquired Methicillin Resistant Staphylococcus Aureus.

In Mississippi, as well as around the country, many people have been experiencing what they thought was a spider bite. After over 300 cases came to my attention in Newton County I stopped counting. 

Newton County native Jerry Crawford’s ordeal with MRSA began with what he thought was a spider bite in one of his children. It had a black target lesion with the outside of the target lesion being red, just as what you would see in a Brown Recluse bite. However, after a couple of doctor visits, an emergency room visit to Meridian, Mississippi, because of swollen lymph glands under the arms and in the groin area of his child.  After several rounds of different antibiotics, they went back to the doctor, and at the suggestion of a friend, requested a culture; it came back as MRSA. Now the whole family is faced with what seems to be a never ending battle.

Kenneth and Carol Hagan became concerned about their son Tyler when he came to them with a lesion that had green and yellow puss, and was spread out in a big area. He told them it had been going on for 4 or 5 days. They became alarmed and took him to the emergency room in Union, Mississippi. The emergency room doctor ask Tyler what he did for a living and he told him he worked for a local contractor. The doctor then told him it looked like a spider bite and sent him around to a surgeon to have an incision and drainage done. They used tweezers to stuff the wound with medicated gauze and put him on Bactrim. Everything cleared up for 7 to 10 days, then he broke out again. First on his left knee and then on his right knee. Soon his temperature hit 104 and we took him back to the emergency room, where once again the doctor diagnosed him with another spider bite. They did another incision and drainage and sent him home. We requested it to be cultured, but when I called the office about the culture whoever answered the phone said everything was fine.
The third time we went back to the ER we told the emergency room doctor that it keeps coming back within a three or four week period and that something was wrong, and it had to be something in his blood or his body. Once again the doctor gave Tyler Bactriban ointment, and Doxycycline, pulled his medical records, and told us his culture came back positive for staph back in June. Naturally I was upset to find out in August that Tyler came back positive for Staph in June. The doctor then told us he had done all he could do, and sent us to an Infections Disease Control Specialist in Jackson, Mississippi. I felt that had I not insisted that the hospital was not going to volunteer the information about the staph.
We went to see Doctor Nancy J Dorman, MD, PHD, Associate Professor of Medicine, Division of Infectious Diseases at University Medical Center In Jackson. She then told us that Tyler had MRSA. She put him on Rifampin and Doxycycline and told us “If this does not work he will have to be hospitalized because it can turn into Pneumonia.” She also says that it is easy for doctors to mistake MRSA for a Brown Recluse bite, but the odds of being bitten by a spider that often is not realistic, and than unless you have the dead spider in your hand, then assume MRSA.
Mrs. X, who wishes to remain anonymous, was a hospital worker and began her nightmare with CA-MRSA with what was diagnosed as a spider bite  She went through round after round of antibiotic, but to no avail. When her children and her husband started coming up with what was diagnosed as spider bites, she had a culture done and it came back as MRSA. (She worked in a lab and got the results herself.) She says that even though she and her children have taken the right antibiotics, the infection keeps coming back.

Most of these patients attribute the infection to spider bites, and may even feel a prick like a bite. However, most of the time, they never see the spider”. The site of infection will usually be inflamed and filled with puss. The sweat gland, especially in the groin area and under the arms can become seriously infected.
According to The Centers for Disease Control website, MRSA that is systemic in nature can be difficult to treat and can progress to pneumonia, life-threatening blood or bone infections, etc., because there are fewer effective antibiotics available for treatment.
Although MRSA is not usually spread through the air, it is possible, and may also spread through direct contact or indirect contact by touching objects (towels, sheets, wound dressings, clothes, sports equipment, etc.) , contaminated by an infected person,

Teenagers are acquiring MRSA through dirty tattoo needles, and MRSA is increasingly becoming a problem for athletic teams, correctional facilities, schools, anywhere you have large groups of people in close contact.

For years scientist have warned us about the misuse and overuse of antibiotics in humans and in livestock. They have warned us that when we take antibiotics to make sure we finish them as directed. They have warned doctors to make sure they wash their hands between patients, and warned hospitals about cleanliness, yet we have not headed the warning. Soon we may all suffer the consequences because the day is fast approaching when the drugs we have may no longer work with life threatening diseases such as MRSA.
The CDC leaves it up to the states as to whether to report CA-MRSA, and as of today, the Mississippi Department of Health does not require all cases to be reported, only those thought to be in clusters, and that is voluntary. Even though there are many diagnosed cases of MRSA in Mississippi, and many were originally diagnosed as spider bites, none have been reported to the local health department. It should be noted that spiders do not carry staph.
MRSA can become colonized in a person and it may make them very sick, but they may also show no signs of infection, but be a carrier. MRSA can become colonized in anyone, even health care workers, so they must take extra precautions like wearing gloves, and washing hands. Especially when coming in contact with MRSA or open wounds or body fluids.
The Mississippi Department of Health may not be taking CA-MRSA seriously, but if you ask CA-MRSA victims should they, the answer is yes. They have battle scars on their stomachs, backs, legs, and arms to prove it, and even though many may have won the battle they are still fighting the war.
There are several reasons doctors and hospitals are not culturing and reporting MRSA. First of all the basic difference between HA-MRSA and CA-MRSA is if the patient had contact or did not have contact with a medical facility over the past year. If a patient is thought to have acquired MRSA through the hospital then some insurance companies and Medicaid will only pay for the original condition not the secondary infection. This causes the hospital to lose hundreds to thousands of dollars on each infection. Another reason is, why should they report how wide spread the MRSA problem is in their hospital when the hospital down the road is not required to do so.
You may be asking yourself the question, “What can I do to protect myself and my family?”

If you have a skin or soft tissue lesion such as a boil, abscess, or celllulitis, or you assume you have been bitten by a spider , have the lesion swabbed by your physician and ask your doctor to do a culture for staph in order to receive the correct antibiotic.
Bobby Engle, Infection Control Practitioner at the University Medical Center in Jackson, Mississippi says , “The key to preventing the spread of MRSA, especially to other family members, is to seek immediate medical attention, and get a quick and accurate diagnosis.” He also stresses the importance of finishing your antibiotics. He says, “Patients often stop taking their antibiotics when they start to feel better and this lets the bug hide out and live to come back stronger. The last pills kill the last bug. and insufficient education of the patient by doctors on how to get rid of CA-MRSA is also contributing to it‘s spread. “
The following are some things you can do to prevent and help curb the spread of MRSA.

1. Wash your hands, or use alcohol hand gels after touching infected skin or bandages to avoid spreading the infection to others.

2. Keep wounds and lesions covered with clean, dry bandages.

3. Avoid sharing personal items (e.g., towels, washcloths, razors, clothes,)

4. Be on the lookout for similar infections in family members and/or close contacts.

5. Others recommend that you wash any clothing you have worn while infected, including sweaters, coats, etc., in Lysol concentrate and hot water and dry at a hot setting in your dryer. The infected persons clothing should also be washed saperately and wear gloves or wash hands when touching infected clothing. This will help prevent re-infection or spread.
6. It may also be wise to disinfect your home, including but not limited to wiping down door knobs, light switches, etc. with a 10% bleach 90% water solution, including your floors.

7. Spray cloth couches, chairs, mattresses, with lysol, and it would not hurt to cover mattresses and pillows with a plastic cover that can be wiped down with a bleach solution
8. When possible the infected person should stay home until MRSA is under control.
While MRSA, if diagnosed correctly, may be very treatable, the wrong diagnosis, the wrong antibiotics, and secrecy is hastening its spread, and all of this is leading up to Vancomicin resistant staph. Vancomicin is our last line of defense against a possible killer.

Just like in New Orleans, the levee is broken, MRSA has escaped from the hospitals, and is here in the community. It is up to us to shore up the levee and stop the flood before it is too late.
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You may contact me at MrsaNews@gmail.com if you would like to share your story.

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