Management of the brown recluse spider bite to the glans penis.

A significant number of people are bitten by the brown recluse spider (BRS) each year. Medical treatment regimens are sometimes unsatisfactory and surgical intervention is often necessary to debride the necrotic wound. This case study reports the treatment given to a 19-year-old active duty United States Army soldier who suffered a BRS bite to the glans penis. This patient received immediate medical attention and was started on intravenously administered diphenhydramine, methylprednisolone, calcium gluconate, and famotidine. Oral dapsone treatment was begun in the emergency room. Within 24 hours after his injury, the patient received his first hyperbaric oxygen treatment, which was continued twice daily for 5 days. Skin necrosis was avoided, the patient did not require any surgical intervention, and he was discharged after 8 days without sequelae.