Saturday, August 23, 2008
Tropical Medicine Eat Your Thigh Out
Barely a day goes by when we don't get someone asking how they go about seeing a decent doctor.
We usually send them to an English doctor who runs a local clinic. He knows his tropical medicine and doesn't scare the tourists too much with his GP-trained British bedside manner.
Earlier this week I had a guy ask me the predictable question. He'd been in the mountains for a while, and whilst there, had been bitten by something unidentified that had run up his trouser leg in a local shop. The bite had now gone bad, swelling up to a massive boil like lump that was oozing something nasty from behind the small dressing he'd put on it. Apparently he had got a friend to squeeze it for him, and as they did so, some little creature had popped out.
Despite feeling quite squeamish by this point, I wanted to follow through and find out what desperate sort of tropical disease or nasty he had picked up, so I sent him off to see the doc with strict instuctions to come straight back and tell us all about it.
Turns out he had been bitten by a brown widow spider.
The brown widow spider has (according to our friends at wikipedia) a venom which is twice as strong as the more famous black widow spider. According to the doctor, the spider had bitten this guy on his upper thigh and deposited some sort of sac just under the skin. Whether this is a stomach sac or an egg sac I do not know - but it may explain the little creature that popped out....
The sac then leaks a neurotoxic substance which eats the surrounding body tissue. Basically necrosis spreads from the site of the bite. The spider sac had hollowed out a little cave like hole underneath the skin and had it been left there, would have continued to do so. Some wounds can get to be inches wide if left unattended.
The doctor excised the wound and stuffed it full of gauze. He was due for another appointment that evening to check on it.
I was concerned about the possibility of infection - really hard to prevent with open wounds in tropical, dusty climates. Especially when you are travelling all the time. But apparently that's very unlikely. Because the tissue is dead, there are no live cells to get infected. Every cloud, etc, etc.
The poor bloke. Two weeks in the mountains and what does he get? A massive necrotic cavity in his upper thigh. He seemed remarkably upbeat about it.