Toxic Spider Bite Causes Woman to Lose Breast

Skeptical toxologists say MRSA bacteria more likely caused infection.

May 21, 2010, 3:44 PM

May 24, 2010— -- By the time Victoria Franklin called her twin sister to take her to the hospital in Atlanta on April 9, her breast had turned black and had blown up to the size of a loaf of bread.

"Her breast was three times the size, black as tar and had a horrible smell," said Valerie Dapaa, 51, who took her nearly unconscious sister to the hospital, where they removed her breast after finding it ravaged by gangrene.

"They call it the smell of death," said Dapaa. "The doctors said they didn't know if they could save her. She was diabetic and her sugar was up to 700."

Doctors told Franklin that she had been bitten by a brown recluse spider, a virulent little arachnid that is seen mainly in the south central part of the United States.

The brown recluse occurs in 15 states, one of them the northern part of Georgia where Franklin lives, according to the Burke Museum of Natural History and Culture in Seattle.

Inside the home, these spiders can be found in dark spots in the bath, garages, closets and cellars. They can nest in boxes of stored clothes and books.

"I don't even remember being bit," said Franklin from her hospital bed.

Franklin's doctors were not available to talk to, but some experts say these spiders are often erroneously blamed for skin infections turned septic -- and without finding the spider, no one will ever know for sure.

After surgery Franklin was in a diabetic coma on a respirator for 11 days. Today, she is at Well Star Windy Hill Hospital in Marietta, Georgia, undergoing physical therapy to regain her strength and awaiting reconstructive surgery.

"I'm doing fine," said Franklin, a 51-year-old divorcee from Hiram, Georgia. "It's really hard for me because I have been an independent lady for so long, and to think this was nearly taken away from me by a spider. That's what scares me -- not losing a breast, but the fact that a spider did me in. I have to learn to do everything all over again."

Franklin, who earns $3,500 a month filling late-night infomercial orders by phone and looks after her two grandchildren on the weekends, has no health insurance. She said she doesn't know how she is going to pay the hundreds of thousands of dollars she expects to owe the hospital for her treatment.

"People have been chipping in and helping, but I don't know how long that will continue," she said.

The twins have not always seen eye-to-eye, but after this brush with death, "We will be close for the rest of our lives," said Dapaa, who works as a cook.

Franklin's condition is known as necrotic arachnidism. Patients report "an abrupt stinging or itching sensation," followed in hours by a painful pimple that within 24 to 48 hours becomes black and necrotic.

"It's a nasty little spider that can cause skin destruction and make an ulcer and let infection in, and in some reported cases it can be very dramatic," said Dr. Marcel Casavant, chief of pharmacology and toxicology at Nationwide Children's Hospital in Columbus, Ohio.

"If you Google it, you can see people losing an arm," he said. "But there are 20 or 30 other things that can do the same thing."

About 60 percent of all brown brown recluse spider bites are false reports, according to the Burke Museum.

Doctor blame "all kinds of mystery skin lesions and gangrenous sores on the bite of a non-existent spider," said Rod Crawford, Burke's curator of arachnids.

"[It's] one of the commoner kinds of medical malpractice, and people have actually died because they were treated for a spider bite they did not have, rather than for the far more serious condition they did have," he said.

The nocturnal and fragile spider, as its name suggests, is shy and seldom encounters humans, according to a 2002 report in American Medical News. Bites can occur when a person rolls onto it in bed.

MRSA More Likely Cause of Infection, Says Doctor

Injury caused by spider venom has been recognized in the United States since the 1950s, according to a 2005 report in the New England Journal of Medicine, which suggested physicians are too quick to point blame, even in areas where they are rare or nonexistent.

"The perceived threat of spider bites far exceeds the risk," wrote authors Dr. David L. Swanson and Richard S. Vetter, who say many other dermatologic conditions are far more dangerous.

"Any small infection in a diabetic can turn into that she had," said toxicologist Casavant. "I wouldn't assume it was a spider."

Experts say the brown recluse spider is often cited in medical and pharmaceutical school training, and doctors are often fooled.

"We actually get calls about this kind of spider bite," said Casavant, who is director of the national poison control center. "A lot come from doctors who think it's the spider even though it's not possible in that part of the country."

"Part of the trouble is doctors are using what they were taught 20 years ago and we now know there is a long list of things," he said. "In the absence of the spider, it's probably something else."

These types of infections can arise when patients have metabolic, endocrine or autoimmune conditions, but more often they are caused by the superbug MRSA (methicillin-resistant staphylococcus aureus).

"In pharmacy school, everybody has a story: That the brown recluse spider likes to hide in the pockets of long coats in dark places and you reach into the pocket of the coast you haven't worn and get bit," said Paul Doering, professor at the College of Pharmacy at the University of Florida.

"But it should be MRSA-phobia and not arachnophobia," he said.

Doering, who did research on the spider as part of a lawsuit against a pharmacist, said that any infection that becomes systemic is cause for concern.

"If an irritation or inflammation gets progressively worse over 24 hours, it doesn't matter what the origin is," said Doering.

Never Ignore a Worsening Skin Infection

"With skin infections today, especially in the world of resistant organisms, you shouldn't take a chance," he said. "The first sign of something, when you feel poorly and there is a red lesion, go to the ER or the doc-in-box."

Such was the case with Franklin, who had three pimple-like spots on her breast that turned to reddened lumps. Within a week, she was crippled with pain and her breast swelled so large, she couldn't get into her bra.

On April 9, she was so alarmed and in so much pain, she called her sister.

"A week before she ended up in the hospital, she didn't realize what it was and started getting sick," said Dapaa, a mother of three and a grandmother. "I was so worried about her and sat four or five hours until the surgery was over."

"I actually saw the wound the next day," she said. "It looked like you could see her ribs. [The doctor] took 40 pounds, the size of a football or a loaf of bread off her breast and the muscle behind."

At first, Franklin couldn't use her arm or legs, but slowly she has been regaining use of her limbs, which have swelled to large, she has difficulty walking.

Dapaa called a friend, who is an exterminator to fumigate the house.

"I see spiders all the time," said Franklin. "But I never knew how dangerous they were. This is very serious. I live in a neighborhood with a lot of children and they play with spiders."

"That spider can kill you," she said. "Its main job is to get in the skin like Pac-Man and eats your flesh and destroys your tissue. That's why I put the story out there. I had never heard of it and wanted to make sure the community knew about it."

"I am working with therapy, going through redressing myself," she said. "I can wash and take a shower. I can't stand for long periods of time. I am walking with a walker."

Franklin said she remains optimistic and plans to move in with her sister Valerie -- at least until she can climb the stairs to her second-floor bedroom in her own home.

"I'm glad it took my breast," she said. "If I had to lose an arm or leg I'd have been torn up. They can do reconstruction on my breast."

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