A 4-inch scar stretches across 6-year-old Barron Bowling's face, a road map to the venom that seeped through his cheek when he was bitten by a brown recluse spider last September. Crushed cartilage makes his right ear fold in half, and a tiny chunk of that ear is missing.
"People say, 'What happened? Were you in a car accident? Were you burned?' " says Barron's mother, Elisa Bowling of Kansas City, Mo. "It's amazing how something so small can be such a big deal."
Brown recluse bites are on the rise across the country, especially in the Midwest and Southeast, says Gary Wasserman, chief of toxicology at Children's Mercy Hospitals and Clinics in Kansas City, Mo. Last year, the hospital treated 29 patients who had been bitten by a brown recluse -- the usual rate is 10 to 12 a year. Since April, the hospital has treated 12 patients; three were admitted to the intensive care unit.
"We're gradually seeing more and more, in worse and worse cases," Wasserman says. "I suspect that's because they're getting used to being around humans."
The brown recluse spider prefers to hide in dark, quiet areas like basements and attics. It typically avoids people and is aggressive only when provoked. It is dormant part of the year, which means bites usually occur from April until October.
Within hours, the spider's venom will begin to kill surrounding tissue, Wasserman says. That creates a bruise that resembles a target.
What makes the bite life-threatening are systemic effects such as hemolysis, or the breakdown of red blood cells, clotting abnormalities and secondary infections.
When Barron was bitten, his face swelled, almost closing his throat. He breathed via a ventilator for four days.
Rick Vetter, a research associate in the department of entomology at the University of California-Riverside, warns that skin lesions are often misdiagnosed as brown recluse bites. They could actually be caused by cancer, Lyme disease, bacterial infections, diabetes or chemical burns.
"There are probably bucketfuls of these spiders in your home, and it's very rare to be bitten," Vetter says. "You shouldn't ignore them, but you also shouldn't freak out about them."
There is no diagnostic test to identity a brown recluse bite. Symptoms include:
Severe pain at the site of the bite.
Muscle and joint pain, coupled with weakness.
Nausea, vomiting and fever.