Naples. The recluse spider psychosis has also broken out in Naples and the surrounding province, and the Cardarelli hospital, as if the summer holiday emergency and overcrowding weren't enough, is being besieged by residents, even by phone.
The bite itself is not lethal but the course must be followed carefully. No psychosis, however, since it is generally a skin lesion that without infection can be treated at home and that only in some situations can cause serious complications.
This is the message coming from the first Poison Control Center in the South, the Cardarelli Center in Naples, directed by Romolo Villani, which provides some useful advice regarding the bite of the so-called violin spider.
"The violin spider has always been present in the South"
"The violin spider It's always been there in the South, as it is throughout Italy. With the latest news, media attention has clearly increased, and with it, the pressure on hospitals., highlights the head physician Romolo Villani, director of the Poison Control Center.
"We've gone from 100 calls a year for insect bites to a situation very close to psychosis, with peaks of 20 consultations a day. But that's fine, as long as we consult specialists and don't rush straight to the emergency room.
In fact, many times these are small skin lesions that can be treated at home, even with the help of photos sent via email or via teleconsultation. At Cardarelli, for example, we have implemented this method: we video call patients when they can't come to the hospital.
Clearly, in the most important cases we invite them to join us in the facility, in the clinic", adds.
This year, Cardarelli became the first Italian center to address the phenomenon scientifically, with the publication in January in the specialized journal Acute Care Medicine Surgery and Anesthesia (AMSA) of a paper titled "Loxosceles rufescens: single-institutional epidemiology, diagnosis, and treatment." This study provides a snapshot of the cases recorded at the Neapolitan hospital in a single year, 63 in 2022, and suggests tools for early diagnosis and effective treatment.
Antonio d'Amore, general manager of Cardarelli, explains: "What's been happening in recent weeks with the brown recluse spider and the high number of inappropriate visits to Italian emergency rooms exemplifies how complex healthcare is and, consequently, how difficult it is for citizens to find the most appropriate service for their health needs. This has resulted in a high number of inappropriate visits to emergency rooms; to reverse this trend, we must raise awareness of the many services offered by our healthcare system."
Today, there's a greater awareness of brown recluse spider bites due to media pressure and the unfortunate events that have resulted from this type of injury, but in the past, many treated them at home. So, what advice should be given to those who suspect they've been bitten? "The first thing is disinfection." explains Villani.
"We first recommend washing the area with plenty of water. In the first 24-48 hours, the bite feels similar to a mosquito bite. Only later may a rash form, often associated with a crust, which can be quite large, indicating that the toxin is able to penetrate deeper. The infection must be monitored and treated with the most appropriate therapies."
When necessary, antibiotics and corticosteroids are administered, based on the therapeutic approach refined over the years and the latest scientific evidence. Surgical consultation for thorough wound debridement or hyperbaric oxygen therapy is rarely appropriate.
Measurement of anti-Borrelia immunoglobulins is also essential. "However, we've had some cases recently, and they've all had positive outcomes," the head physician emphasizes. Early diagnosis and the involvement of specialized personnel are therefore the key. "Timeliness is key," Director Villani emphasizes.
"If you're sure you've been bitten by a spider," he concludes, "you should contact your nearest Poison Control Center, possibly sending photos of the arachnid for identification, or rely on expert specialists, such as dermatologists or infectious disease specialists."
The Cardarelli Poison Control Center answers the numbers 24 hours a day 0817472870 or 0815453333, while the email address is cav@aocardarelli.it
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