I would like to tell you a tale. This is not a tale for the faint of heart of the weak of stomach. You have been warned. (Honestly, the photos I'm about to post are a little gnarly. My apologies in advance!).
This is a tale of intrigue. Of mystery. But mostly, it is a tale about maneuvering the great bureaucracy that is the Danish medical system.
ooooooooh!
ahhhhhhhh!
My friend Tiffany showed up to work the other day with a mysterious sore on her leg. She said she woke up that morning, dragged her tired self into the shower, and then noticed a burning sensation on the back of her calf.
She photographed it post-shower (seriously smart move!), recognizing how unusual it was. She wanted a baseline photo, should it start to get worse (honestly, genius!).
So, as shown, it started as a rash, with a kiss-shaped mark in the center.
By the time she got to work, it looked like this:
I freaked. I had a case of arachnophobia a while back, and at one point spent a fair amount of time looking up creepy spider bites. It looked to me like the start of a crater-sized scar, caused by a brown recluse, black widow, etc...
"Get yourself to a doctor, lady!" I said. She kept working, complaining about the burning, all the while, before finally parading her mysterious blisters around the office, asking for advice on how to see a doctor. Everyone's response? "I know you think it's a spider bite, but there are no spiders in Denmark!". Absurd. I've seen spiders. Either way, toward the end of the day, she finally got a doctors appointment, with a special after-hours doctor at 4 pm (yes, that's after-hours. Again. Absurd).
She later called me, telling me all about her trip to the "doctor". Apparently, the medical campus looked like an ivy league school, it was impossible to navigate, and the doctor she saw was a hot 2o-something in running clothes, who told her she probably scratched herself. Or maybe she got stung by a bee. But no way was it a spider bite. "There are no spiders in Denmark". He marked the size of the wound and said "come back tomorrow and we'll see if it has gotten worse". Oh cool. Comforting.
The next day, two blisters melded into one. Awwwww, cute!
She saw more doctors, and none of them ran a single test. One wanted to pop the blister and treat it like a burn. Funny thing? If it is in fact a gnarly spider bite, burn cream is one of the worst things you can apply to it. Smarty-pants Tiffany said "no way, jose". Another doctor tried to prescribe an antihistamine. Luckily, the pharmacist said "this medication is going to do absolutely nothing for you" and wouldn't sell it to her. That pharmacist got three gold stars that day for being the only non-quack in the system.
She also called a doctors office with the traditional hours of 9-11 am, three days a week. She didn't call within the oh-so-generous hours of operation, and got not even so much as an answering machine.
Yesterday, the blister finally popped.
Yum!
And today? It started to hurt her like crazy, and it's begun to look like a mad science project, or an awful case of bed-rot (so sorry, Tiff. Thanks for being such a trooper!).
Today, after talking to 12 or so doctors, even calling her own doctor from Harvard, back in the States, she finally saw someone who took a swab of it to test, who said "maybe it actually is something serious." We also read an article, explaining that black widows (and maybe other poisonous species??) entered Sweden in 2008 in cars imported from the southern US, and that they're now accepted as having become a part of Scandinavian fauna. Sweden is right next to Denmark. If they can come over in cars from the US, how is it that they're kept out of Denmark? Let's get real.
The doctor suggested that it's maybe a staph infection. Perhaps. But I'm sticking with my original theory (and I'm willing to be proven wrong!). Humans haven't always existed on the planet. Species evolved in the galapagos at record speeds. Maybe it's time for the Danish to cut out the part of their national anthem that says "And the Danes have never seen a spider. There are no spiders in Denmark," because lookie what I found just yesterday, comfortably hanging out among the spokes of some poor shmuck's parked bike:
Oh, what's that? A spider?
Proof! Now would you please treat my friend?
...stay tuned.
dooode....HOW did it get so infected? I assume you're keeping it surgically clean, yes? Venom alone can't do that! That said, it doesn't look like a spider bite. Normally, you can see the original bite marks before the wound becomes necrotic. Also, the area around the spider bite would normally be swollen before blistering.
ReplyDeleteAnd if it were a spider bite, I'd guess brown recluse before black widow because you described a burning sensation and progressive pain that seems localized to the bite area -- black widow bites tend to affect the central nervous system and cause internalized pain, most often to her abdominals (yes, I had my bout of arachnophobia once too).
If it's just an infection, staph or otherwise (doesn't look like staph, they're normally boils and there'd be more than one), she'll want antibiotics asap and hopefully won't need a skin graft (it looks small enough). Necrosis wounds don't usually heal too well... Good luck, and best wishes to your friend!
A bite alone can and absolutely does do that! Especially from a brown recluse spider. And I would imagine an allergic response could exacerbate it as well. Google pictures of brown recluse spider bites.
DeleteAlso forgot, if you aren't already using it, hydrogen peroxide should be safe to use around, but not IN the wound (check with a doctor first). I think it goes without saying not to let ANYTHING touch it.
ReplyDeleteDr. Daniel! I had no idea. I'll pass along the info for sure.
ReplyDeleteHey! This exact same thing happened to me in 2012. Also on the back of both my calves. I saw 7 doctors and they all said it wasn't a spider bite because "there are no biting spiders in denmark."
ReplyDeletePhooey, I say. Phooey.
They treated mine like a burn and it took 9 months just to close. I now have a huge scar and still have no conclusion as to what it was. Did you ever hear what happened to genius Tiff?? I need answers!
You can see a list of spiders in denmark on this site: http://www.jorgenlissner.dk/default.aspx
ReplyDeletewith f data from the Fauna Europaea Database v. 2009.1, The World Spider Catalog v. 10.0 an unpublished reports.
As far as i can tell none of them a medical concern. Even in North America it's only the brown recluse and the black widow that is a medical concern.
In any case doctors in Denmark are highly unlikely to encounter necrotic lesions from spider bites and as the saying goes: when you hear hooves think horses not zebras.
Funny enough the wikipedia site for zebras (medicine) sites that: "Necrotic skin lesions in the United States are often diagnosed as loxoscelism (recluse spider bites), even in areas where Loxosceles species are rare or not present. This is a matter of concern because such misdiagnoses can delay correct diagnosis and treatment"
In USA the "horse" in is the brown recluse bite.
That is a classic spider bite. Not sure what kind of "doctors" and experts you all seem to be. That is definitely not a staph infection. It does not even appear to be a secondary staph infection. Venom alone (depending on spider) can DEFINITELY do that. You Denmarkians need to step up your medicine game.
ReplyDelete