Keith Pierce (10) died from a spider bite

[puzzld]

Authorities say a 10-year-old Montana boy has died of complications from a spider bite.

The Gallatin County Sheriff's Office said Keith Pierce died at a Billings hospital at about 2 a.m. Monday.

The coroner is investigating, but a forensic examination completed Monday determined the boy died from a severe infection caused by the bite.

The boy's mother, Mandy Pierce, talked with KZBK-TV and said they took Keith to the hospital after his leg started to swell Sept. 30. After ruling out cancer, Keith was sent home.

Days later the pain and swelling in Keith's leg prompted another trip to the hospital where Mandy told KZBK say doctors performed emergency surgery Sunday morning from which Keith never woke up.

According to KZBK, the parents had to decide to end resuscitation efforts early Monday morning.

Mandy told KZBK that parents need to learn more about brown recluse spiders and talk to an exterminator about having your house sprayed.

According to the Remembering Keith Pierce Facebook page, a benefit auction for the Pierce family will be held on Saturday, October 18.

The Three Forks School District brought counselors and ministers to the boy's school Monday to speak with parents, teachers and students.
http://www.kirotv.com/news/news/bite...2014_partners1

https://www.facebook.com/rememberingkeithpierce

[Angiebla]

A girl I went to school with was bit by one of those spiders. There was a big brown spot in the middle of the bite. You couldn't miss it.

[Bumble Gum]

The hospital sent him home with his leg still swollen?

[Angiebla]

The hospital sent him home with his leg still swollen?

Yeah because they ruled out cancer, and that's obviously the only thing in the entire world that could cause someone's leg to swell.

[Boston Babe 73]

Hospitals are all about sending fatally ill people home lately. Nice.

Very sad

[Queena]

Yeah because they ruled out cancer, and that's obviously the only thing in the entire world that could cause someone's leg to swell.

I can't rep from my phone, but you're right. Doctors think they know everything.

[Nic B]

How could they not see the bite? My friend's mom was bit by one and it was obvious. Her skin around it started turning black, really gross.

See, this is why I get frustrated when someone gets annoyed if I freak out over a spider. "It won't kill you." You sure about that?

[UncomfortablyNumb]

I fucking hate bugs. And I agree...anytime I have ever been bitten by a spider, I could see 2 holes in the center where their devil fangs went into my skin....I hate it when ER doctors just want to get you out of their hair and don't fucking pay attention.

[marycontrary]

I think ER physicians do a poor job of actually diagnosing and treating illness. If you present to the ER with obvious injuries, like a limb cut off, they do a pretty good job of finding a surgeon and getting you fixed up. If you have an illness, they pretty much just stabilize and send home and tell you to follow up with your family doc. They also have a horrible attitude with patients who come in ill in the middle of the night and make them feel like the patient is making mountains out of mole hills and are taking up a bed that a sicker patient needs. These attitudes make it difficult for the patient to feel comfortable to come back when symptoms get worse. We had a patient in outpatient surgery who was suppose to get a port a cath for cancer treatment. In the pre op process she had an EKG which indicated she had had a heart attack at some time. She was questioned about chest pain and told us that she had visited an ER with chest pain a couple weeks prior and was sent home. We called the hospital she had this EKG in and had them send us a copy of the EKG she had there. The EKG showed she was having a heart attack and the ER she used had physicians in India who read the EKGs. She was sent home before the EKG got read and due to a failure of communication, she was not called to return. She couldn't have her port surgery until she got a work up from a cardiologist. You would think that trained ER physicians could at least be trained well enough to determine the difference between a normal EKG and one indicating a heart attack. We all know stories of women who die from heart attacks after being sent home from the ER complaining of chest pain. It's all about herding people like cattle through the ER and freeing up beds. The attitude being that the patient is stable, send them home to follow up with their own physician.

[blighted star]

It's the same here. Of course when you go follow up with your family dr they tell you that you should go to Emergency if you feel your symptoms are serious & around you go again. Yay.

[Angiebla]

Yeah because they ruled out cancer, and that's obviously the only thing in the entire world that could cause someone's leg to swell.

I'm quoting myself because I wanted to clarify that I don't dislike emergency room doctors and nurses. They have a protocol triage they follow, and I'm sure a swollen leg is low on the list. They probably did an X-Ray to check for broken bones, and after finding none, they came to the conclusion there was a soft tissue injury.

I would like to know if the area he was bit was visible, and not covered in clothing. Doctors use deductive reasoning to find out what is going on with a patient. I'm pretty sure spider bites make up for .2% of all the cases that come into the ER.

[puzzld]

From identifications to cataloging species present in Montana, experts with Montana State University Extension often address questions about spiders.

Schutter Diagnosic Laboratory on the MSU campus offers information and help to the public in identifying spiders and other insects.

While there is conflicting information on the Internet and in the media, the brown recluse is not native to and cannot survive in Montana?s cold, dry climate. Its native range is from southeastern Kansas south to Texas and east to western North Carolina and south to southern Georgia.

?It is extremely unlikely that any spider bite from this area is from a brown recluse,? said Lauren Kerzicnik, insect diagnostician at the Schutter Diagnostic Laboratory. ?While we often receive submissions from people wondering if a spider is a brown recluse, we have never positively identified one in Montana.?

Identifying a brown recluse is difficult because it has a violin pattern that is common to many spiders. Brown recluse spiders have six eyes that are arranged in three pairs of two behind its head. To be sure, identification of a brown recluse must be done by a trained arachnologist or entomologist.

Brown recluse bites are consistently misdiagnosed in areas where the spider is not present, including Wyoming, Colorado and Montana. The venom of brown recluse spiders contains a component called sphingomyelinase D, which creates mild to severe necrotic lesions in the immediate area of the bite.

Reactions to the toxin in the venom delivered from the brown recluse bite mimic several other types of medical issues, including bacterial infections, chemical and allergic reactions, lymphoma and other conditions. The spider is often erroneously blamed for bacterial-caused rashes and lesions that have nothing to do with spiders or spider bites but, rather, are caused by some other wound or puncture that allows bacteria to enter the body.

Bites from brown recluse spiders do not typically cause body-wide or systemic reactions. The venom itself does not cause infection. Instead, the open wound creates an entry point into the body for bacteria. The only way to confirm that a spider or insect is responsible is if the specimen is captured and identified.

The only spider commonly found in Montana with venom harmful to humans is the black widow. Its venom causes latrodectism, which results in persistent sweating, muscle cramping, and other neurological responses. Bites from black widows are very rare.

The hobo spider, which has also been called the aggressive house spider, is present in most of central and western Montana. It does not cause necrotic lesions and is not directly harmful, despite misinformation on the internet. There has been significant research on this subject over the last decade and any suggestions that hobo spider bites or lesions are dangerous has been discredited. Nevertheless, if a wound becomes inflamed or soreness persists, medical care should be sought as secondary infection can enter the body through the wound.

To minimize the risk of spider bites, take caution when working in crawl spaces, garages, the laundry room, and in areas that are not often encountered. In general, bites are rare from spiders because they are small, their fangs are small, and they lack the musculature to pierce the human skin. If think you have a spider bite, see a dermatologist if your symptoms persist.

Facts about the brown recluse and other spiders in Montana:

The brown recluse has never been positively identified in Montana

The brown recluse bite causes localized necrotic lesions on the skin due to a toxin in its venom

Necrotic lesions can be caused by several factors, including some spider bites or secondary infections in the bite area

The most common cause for such necrotic lesions in areas of the country where brown recluse spiders are not found (such as Montana) is MRSA (Methicillin Resistant Staphlococcus aureus infection)

A brown recluse spider must be identified by an experienced professional

The black widow is the only spider harmful to humans that has been identified in Montana

Hobo spiders are present in Montana but are not aggressive and do not cause necrotic lesions

If you find a spider or insect of concern, please place it in a leak-proof container and either freeze it or preserve it in rubbing alcohol. Bring the sample to your local county Extension office or send it to the Schutter Diagnostic Lab at 119 Plant BioScience Bldg, PO Box 173150, Bozeman, MT 59717-3150.

Read more: http://billingsgazette.com/news/stat...#ixzz3GGSp9Vm8

[Boston Babe 73]

That's all fine and dandy, but regardless of IF they could have known it was a Brown Recluse or even a spider bite, they sent a kid home who was obviously having a serious problem.

I would hope in this day and age of technology, that Doctors could somehow seek second opinions by sharing the photo around with a network of other doctors and admit him until they determine the problem.

The new trend of slapping a pharmaceutical at someone and sending them home instead of trying to determine the cause of the problem is not a good one. It's what happened here and it's what happened in Dallas. People need to start using their brains to think outside of the box instead of adhering to a set list of rules, standards and answers. ESPECIALLY in the medical industry.

[puzzld]

That's all fine and dandy, but regardless of IF they could have known it was a Brown Recluse or even a spider bite, they sent a kid home who was obviously having a serious problem.

I would hope in this day and age of technology, that Doctors could somehow seek second opinions by sharing the photo around with a network of other doctors and admit him until they determine the problem.

The new trend of slapping a pharmaceutical at someone and sending them home instead of trying to determine the cause of the problem is not a good one. It's what happened here and it's what happened in Dallas. People need to start using their brains to think outside of the box instead of adhering to a set list of rules, standards and answers. ESPECIALLY in the medical industry.

I suspect the family doesn't have insurance, so really what could they expect.

[Boston Babe 73]

I suspect the family doesn't have insurance, so really what could they expect.

Certainly to not have their Son die.

[bowieluva]

Yeah welcome to America, where paperwork is more valuable than a human life.

[Angiebla]

Certainly to not have their Son die.

I don't think this was the hospitals fault.

[bowieluva]

I don't think this was the hospitals fault.

Really? They diagnosed a swelling leg as possible cancer, which is a fucking stretch and a half, and then sent him home like 'welp, we have no idea.'

Wouldn't the first thing you'd think be 'oh allergic reaction'. And look for a mark? Or say 'did something bite you recently?'

[Angiebla]

Really? They diagnosed a swelling leg as possible cancer, which is a fucking stretch and a half, and then sent him home like 'welp, we have no idea.'

Wouldn't the first thing you'd think be 'oh allergic reaction'. And look for a mark? Or say 'did something bite you recently?'

Read my post above. You have no idea what extent they went to to find out what was causing the swelling. They aren't going to assume it was a bug bite, they are going to think it was from some kind of injury.

If there wasn't a mark with necrotic skin in the middle then I doubt it was a brown recluse bite.

[bowieluva]

Read my post above. You have no idea what extent they went to to find out what was causing the swelling. They aren't going to assume it was a bug bite, they are going to think it was from some kind of injury.

If there wasn't a mark with necrotic skin in the middle then I doubt it was a brown recluse bite.

If it is rapidly swelling, as opposed to swollen, as described, I politely disagree completely. Swelling indicates an allergic reaction, at the very least. A bee sting can leave no mark but cause rapid swelling and eventual death.

[UncomfortablyNumb]

Maybe I'm an idiot, but does it say that his whole leg was swelling or if it was just a certain area on his leg that was swollen? I read the article, but it didn't clarify that for me. I've had a spider bite on my arm before and I got a HUGE swollen lump on my arm. It was hot to the touch and it hurt and itched like a muhfucker. But it eventually went away.....I've heard recluse bites look nasty, so I wonder if maybe his didn't resemble the typical recluse bite?? Or the ER really just didn't give a fuck?

[TupeloHoney]

Interestingly, I know two people who, in the last 15-20 years, were told in the ER they had been bitten by a brown recluse but ended up having a staph infection instead. (I also know people legit bitten by recluses.)

Anyway, I was surprised to learn that this kid was from Montana, because that's far from the native habitat of the brown recluse spider. I only know this because I read a lot about spiders. (I was terrified by them as a child/teen, but now I think they're awesome.)

While it's possible a brown recluse made its way to Montana in a shipment from somewhere or in some moving boxes, I'm not convinced that's what happened here. Many necrotic wounds are misdiagnosed as brown recluse bites, and what's crazy is that happens more frequently in areas that don't have brown recluses than areas that do. Any spider bite can become infected. (And, in addition to staph, Lyme disease is easily mistaken for a BR bite).



Here are several links:

http://www.greatfallstribune.com/sto...says/17272753/

http://www.abcfoxmontana.com/story/2...n-recluse-bite

http://billingsgazette.com/news/stat...0d5e1a514.html



This link is especially helpful: http://spiders.ucr.edu/necrotic.html:

In a study published in October 2003, four western U.S. arachnologists were contacted in regard to 216 brown recluse spider bite diagnoses made in California, Oregon, Washington and Colorado in 41 months. In contrast, only 35 brown recluse or Mediterranean recluse spiders could be verified as EVER being found in these 4 states. None of these 35 spiders was involved in an envenomation and in the 67 years of our collective experience, not one "recluse bite" victim has ever submitted a brown recluse to us for identification. In contrast, homeowners from endemic recluse areas submit brown recluses for identification about 70% of the time and people with necrotic skin lesions submit a recluse spider about 10% of the time. What should be becoming apparent to you is that 1) recluses spiders are common where they are found, 2) you need decent populations of them before you get a significant probability of a bite from one and 3) doctors from non-endemic areas are diagnosing bites from these spiders far out of proportion to the actual number of spiders that can be historically found in their states.

[bowieluva]

If you google 'Southern California brown recluse' you will find there's a really hot debate about their existence, because the official take is no but then about a billion people, myself included, have seen them, taken pictures, and been like 'okay what is this then?'

Reminds me of one of my friends who grew up in a region where people were reporting mountain lions and they were told NO YOU ARE IDIOTS THOSE AREN'T MOUNTAIN LIONS, like zoologists paid for this article about how wrongy wrong they are to go in the paper, and then a guy replied with a picture of a huge ass mountain lion on his porch with 'okay, what is this?'

[TupeloHoney]

If you google 'Southern California brown recluse' you will find there's a really hot debate about their existence, because the official take is no but then about a billion people, myself included, have seen them, taken pictures, and been like 'okay what is this then?'

Reminds me of one of my friends who grew up in a region where people were reporting mountain lions and they were told NO YOU ARE IDIOTS THOSE AREN'T MOUNTAIN LIONS, like zoologists paid for this article about how wrongy wrong they are to go in the paper, and then a guy replied with a picture of a huge ass mountain lion on his porch with 'okay, what is this?'

Yeah I knew there has been much debate about brown recluse spiders in California.

But there are just so many brown spiders running around that resemble them. Hell, I know we have them here, and there's been about a million times I was certain I was looking at a brown recluse and discovered I was not. The whole "fiddleback" thing can be confusing because other spiders have similar markings.

I rented a really old house back in the day that was full of cellar spiders. I spent many hours on the internet trying to figure out what they were because I really thought they were recluses.

There are also several varieties of funnel-weaver spiders (we have them here in our yard) that look a lot like a recluse. And while female Southern house spiders don't look like a recluse, male Southern house spiders do.

I'm definitely not saying you've never seen one, but there are other recluse spiders that live in California ... the desert recluse and baja recluse ... and they're almost identical to a brown recluse, and I don't know how anyone can tell the difference. I can't.

There's also the Martha's recluse, Russell's recluse and the Arizona recluse. Too many recluses!!!!



Don't even get me started on brown widows, which are brown with an orange marking when they're young but turn black as they mature.




I don't know what to say about the mountain lions ... except that I don't want to run into one, haha :)

[Angiebla]

Has it been verified that they are 100% sure it was a brown recluse that bit this kid?

According to the map that TOH posted brown recluse are not indigenous to Ohio, but I know a couple of people that have been bit here. Is it too cold here for them?

I also thought hobo spiders weren't poisonous, but more of a nuisance?