Which is worse: The brown recluse spider, or the near-mythic fear it provokes? 

Buggin' Out

Buggin' Out

If you live in Tennessee, you've heard the horror stories. Terrifying tales of lost limbs, gaping holes in flesh, unsightly scars — battle wounds at the fangs of the Loxosceles reclusa, otherwise known as the Southeast's most notorious eight-legged freak: the brown recluse spider. Discussing the deadly arachnid — and its poisonous partner in crime, the black widow — is as much a summer pastime for Nashvillians as singing "Sweet Caroline" at Fenway Park is for Bostonians. Chances are you know someone — or perhaps more accurately, you know someone who knows someone who knows someone — with a story about how the spider crept into their bed, fangs dripping with flesh-eating venom, and roused them with the pinprick pain of its bite.

The result, in extreme cases, is a severe skin infection called necrotizing fasciitis. The condition starts off as a discolored, blistering wound. Over a period of days or weeks, it slowly bores into the tissue below, dissolving the flesh. At its worst, the condition can lead to amputation, sepsis, tetanus (for those who aren't vaccinated) — or in rare cases, death.

Go online to confirm such stories, and the first thing you'll see is probably a picture of a swollen, rotting thumb, or an amputated foot surrounded by lesions resembling moldy hamburger meat. Keep scrolling and you'll see pictures of the eight-legged predator itself.

In some photos, it stands atop a quarter to show its size. Spindly legs spike out from a waxy brown abdomen. Look closely, if you're so inclined, and you'll see the arachnid's mark of distinction: a darkened dorsal pattern in the uncanny shape of a Stradivarius — the world's smallest violin, if you will. It gives the creature its colloquial name: the fiddleback spider.

Still not certain what you're facing? Get even closer, and check if the arachnid in question has six eyes, arranged in pairs. Most spiders have eight eyes, arranged in rows. Not the brown recluse, endemic to Tennessee, which resides in many homes here — and holds a reputation as "the deadliest spider in North America."

At least one high-profile case from recent years would seem to bear this out: a terrible incident three years ago in Macon County, Tenn., where a toddler went overnight from apparent health to devastating symptoms and eventual death. Given the rampant horror stories about the brown recluse, however, that incident is somewhat shockingly rare. In 12 years working as a forensic pathologist in the Davidson County, Tenn., Medical Examiner's office, Amy McMaster Hawes says she has never personally seen a death from a brown recluse bite.

"Overall, I can say for Davidson County that deaths due to snake bites, spider bites, bee stings are extraordinarily rare," Hawes tells the Scene. "They're so rare that I can't think of any off the top of my head."

Other experts in the field, from doctors to entomologists, have heard their share of secondhand horror stories. But from the trenches, they tend to report cases that are far less drastic. The same goes for other widely feared Tennessee pests such as wasps, hornets, ticks, mosquitoes, copperheads and rattlesnakes.

"I think the misconception is that the majority of bites end up with a lot of tissue loss that leaves big holes in people, and that's not the case," says Donna Seger, executive director of Vanderbilt University's Tennessee Poison Control Center. "By far, the majority of bites, if you leave them alone and they're properly taken care of, will do very well."

Getting bitten by a brown recluse is common in Tennessee, Seger says, noting that the native species is a nearly ubiquitous nuisance.

"It's almost impossible to avoid them," she explains. "In the grand scheme of things, I'm really surprised there aren't more [bites]," though the anti-social spider is known to be non-aggressive and avoid contact with humans.

What's uncommon, Seger says, is a bad result.

"It's like that thumb you see on the Internet," she says. "I mean, people go on the Internet and see that and go, 'Oh my God, I'm gonna lose my arm, or I'm gonna lose my leg,' which just isn't the case."

So which is it? Is the brown recluse a lethal menace making every Middle Tennessee home a potential deathtrap? Or is fear of the spider, and similar vermin, more dangerous than the bite itself?

The truth lies somewhere in between, peering out of the darkness through six wary eyes.

According to the Tennessee Department of Health, 2,062 Tennesseans went to statewide emergency rooms for spider bites in 2012. Of these, only 287 required in-patient hospitalizations. Regarding gory Google image results of decaying thumbs or fist-sized holes in necrotizing flesh, Seger says she has never seen a scenario that extreme in 25 years of treating two or three brown recluse bites a week.

What's more, in her quarter-century in the field, Seger says she's only sent one spider bite victim in for a skin graft — indicating that when it comes to the myth of the brown recluse, the exception drives the fear.

Exceptions like the ordeal suffered by Nikki Perez, a 21-year-old Texas Christian University student who was bitten by a brown recluse at Amarillo International Airport in 2012. Swelling from the bite ballooned half her face to nearly twice its normal size, forcing her eyes shut and temporarily blinding her, according to a story in Britain's Daily Mail.

In April, here in Tennessee, Anderson County Commissioner Chuck Fritts stepped into a pair of boots he kept outside, and nearly lost a foot as a result. Shoes, stowed bedding and seldom-worn clothing are common hiding places for the literally reclusive spider, which Fritts believes was the culprit behind the fast-spreading necrotic infection that sent him to an Oak Ridge hospital for emergency surgery.

Muddying the water are stories like that of Slayer guitarist Jeff Hanneman, whose unexpected death was mourned around the world in May. The 49-year-old heavy metal legend died of liver failure, and reports speculated that the disease originated with a bout of necrotizing fasciitis that sidelined the guitarist in 2011, nearly claiming his right arm. Hanneman claimed he'd contracted it from a spider bite in a friend's Southern California hot tub.

But an autopsy later revealed the rocker's death was due to alcohol-related cirrhosis — a far more common cause of liver failure than spider bites. Not only did the fatal illness have nothing to do with the guitarist's necrotizing fasciitis, it's unlikely Hanneman was bitten by a brown recluse. The spiders don't dwell in California.

What's more likely is that Hanneman's necrotic wound came from a bed sore, or some other kind of bacterial infection. Anthrax, Lyme disease, diabetic ulcers and lymphoma can all cause necrotizing fasciitis. Even in states that aren't home to the brown recluse, doctors often misdiagnose necrotic infections as the result of spider bites.

On Facebook, the Scene asked readers to share their spider-bite horror stories. Most had unpleasant accounts of infection or mild necrosis that ended quickly, with mild scarring at worst. These checked out as firsthand experience.

The most dramatic tales, on the other hand, were the unverifiable secondhand sort that urban-legend specialists call "FOAF" (or "friend of a friend") stories. These included a former MTSU student and his girlfriend attacked in bed by hatching baby brown recluses; a guy who lost a pinky finger after sticking his hand in an infested work glove; and a Virginia funeral home employee who claims to carry an EpiPen because doctors say one more brown recluse bite will trigger a fatal allergic reaction.

In addition, two Tennesseans say they were bitten in New York City, where there are no brown recluses. Even so, one such victim tells the Scene that ER doctors treated the infection as a recluse bite anyway, just in case. "They gave me antibiotics before they ran any tests," she says.

"In areas lacking brown recluses, doctors routinely make bite diagnoses," Richard S. Vetter, a researcher in the department of entomology at the University of California Riverside, wrote in a 2002 study. "If brown recluse spiders were truly responsible for these wounds as doctors claim, then brown recluse spiders should be readily found in these areas."

A top researcher in the field, Vetter has worked overtime to dispel the myth of the brown recluse. "The brown recluse is the Richard Jewell of the spider world," he wrote in a 2002 editorial, referring to the man mistakenly suspected as the Atlanta Olympics bomber. Vetter's groundbreaking 2002 Journal of Medical Entomology study focused on Diane Barger, a woman who, over a six-month period, collected a staggering 2,055 brown recluse spiders in her family's 1850s-built four-person home in Lenexa, Kan. Despite this Syfy-worthy infestation, Barger and her family had lived in the home for eight years without a single bite.

"You would think that's an incredible infestation, and people are going to die," Vetter told ABC News at the time, further claiming that, though brown recluse deaths have been reported, not one has ever been confirmed in the United States. A 1998 finding by Dr. Phillip Anderson, one of only a few clinicians in the U.S. to specialize in researching brown recluse bites, backed up his claim at the time.

"Several deaths from loxoscelism were reported in medical journals, but none of the reports is convincing," Anderson wrote in the journal Missouri Medicine. "We are not aware of any verifiable deaths caused by the bite of the North American brown recluse spider."

Reached by the Scene this week at his home in California, Vetter said that in the intervening years since his pioneering study, a few cases of deaths attributed to brown recluse bites had come to light. But he insists that the spider's deadly reputation has been grossly exaggerated.

"I know I wrote that at one point — that there were no confirmed deaths — because at the time, from the medical literature I had access to, which was most of it — I've been studying this stuff for 20 years — there really were no confirmed deaths, and in talking to some physicians in the last couple years, they have said, 'Yes, there have been a couple deaths from recluse bites,' " Vetter says. "Overall, it's one of those things of, people are looking for a black-and-white situation: Are there deaths or not? Well, yes and no. And the real question is: Are they that big of a deal? The answer is no."

It is certainly true that recluse fatalities are so rare that medical personnel contacted by the Scene said they'd never personally seen one. At the same time, an autopsy report obtained from the Tennessee state medical examiner's office confirms at least one death by brown recluse bite three years ago in Macon County — and under the saddest of circumstances.

The victim, a 3-year-old named Kaylee Davis, was hiding in an old blanket when she complained of a sudden pain. Her family had the presence of mind to capture the tiny spider they found crawling on Kaylee's chest. They took her and the spider to the emergency room at Macon County General Hospital, where she was treated and released.

The next day, however, Kaylee showed a drastically high fever. The toddler began vomiting and urinating blood. She was rushed to Vanderbilt University Medical Center and given a blood transfusion, to no avail. The child died Sept. 1, 2010. The cause of death, under circumstances of being "bitten by brown recluse spider," was listed as "systemic loxoscelism" — the worst-case scenario for recluse bites.

Brown recluse venom is a hemotoxin that breaks down blood cells. It can cause systemic loxoscelism, a type of blood poisoning that produces agonizing flu-like symptoms and skin rash resulting in hemolysis — internal bleeding dire enough to require a blood transfusion.

According to Jennifer Lowry, a pediatric doctor at Kansas City's Mercy Children's Hospitals and Clinics who is currently working to publish a handful of confirmed cases, the disease's relative obscurity makes it difficult to find records of recluse bite deaths.

"[Systemic loxoscelism] is not a reportable illness, according to most states, so they're not going to document that anywhere other than a death record," Lowry says. "Most of the time, when you look at a death report, [it's] not going to say, 'death from a spider bite [or death from systemic loxoscelism].' "

Told that Kaylee Davis' autopsy report indicated death resulting from a brown-recluse bite, Vetter said, "I see nothing to disagree with that."

Some people are far more susceptible to systemic loxoscelism, especially small children, and after a case as horrible as Kaylee Davis', a parent's paranoia is understandable. But Seger says the vast majority of the populace would not react so violently.

"There certainly are serious side effects of the brown recluse spider bite, and why some people get the systemic reaction — which is a small percentage, the majority of them don't — nobody really knows why," Seger says. "It probably has more to do with the makeup of the red [blood] cells."

Still, she says that the bites do have potential for great harm. In textbook cases, she explains, bites form a thick, blister-like lesion on the skin, with an area of purplish discoloration around it that spreads to the surrounding tissue.

"If you just leave it alone, the scab will pull away from the edges and fall off," Seger says. "[But] they can look very bad." She notes one recent patient who was bitten on the underside of her upper arm, resulting in a temporarily grotesque 2-by-3-inch infected scab.

Bites, however, may not be to blame for the severity of some of these infections. According to the medical professionals contacted by the Scene, folk remedies and home treatments culled from the Internet can turn a simple bite into the horror-movie material found online.

"Because there are so many urban legends about these spiders, people put a myriad of things on them," Seger explains. "I've seen people that have put coffee grounds on them, or mud." One commenter on the Scene Facebook thread claims he cured his brown recluse bite with a concoction of basil, oregano and clove essential oils.

"And that's the problem," Seger counters, "because [that's how] they get infected. They look bad, and because they're red and the rash around them spreads so quickly, people think they've got a rip-roaring infection, and that's not the case — it's a response to the toxin. So what's really hard to do is convince people not to do anything."

Seger advises against treating bites with household ointments like Polysporin. Instead, she recommends that bite victims just take a shower, let the area dry, and keep an eye on the wound.

"[The bites] do well by themselves if you leave them alone. What you don't want to do is cut them out and all these other kind of remedies," she says. "If you cut on them, they get worse. If you try and cut around the area and take it out, you end up with big holes that don't heal well."

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