Several doses at 4-h intervals may be necessary. Narcotics and hot baths may provide relief. If the bite is on an extremity, the extremity should be elevated until the bite has healed. Use of hyperbaric O 2 therapy has produced some clinical improvement in only a few patients. Ulcerating lesions should be cleansed daily and debrided as needed.
Most bites require only local treatment.
Surgical excision, if necessary, should be delayed until the area of necrosis is fully demarcated. Systemic manifestations are treated symptomatically. Systemic corticosteroids have shown no consistent or reliable benefit. All rights reserved.