Spider bites: Difference between revisions
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**[[Tarantula spider bite]] | |||
=== | ===Visual Spider Identification== | ||
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==Clinical Features== | |||
===History=== | ===History=== | ||
* Determine circumstances of bite to assess consistency with spider habitat and behavior | * Determine circumstances of bite to assess consistency with spider habitat and behavior | ||
Revision as of 13:24, 29 May 2022
Background
Clinically important spider genera by geographic region
- North America
- Loxosceles (e.g. brown recluse)
- Latrodectus (e.g. black widow)
- Tegenaria
- South America
- Loxosceles
- Latrodectus
- Phoneutria (e.g. armed spider)
- Africa
- Loxosceles
- Latrodectus
- Europe
- Loxosceles
- Latrodectus
- Australia
- Atrax (e.g. funnel-web spider)
- Hadronyche (e.g. funnel-web spider)
- Latrodectus
- Asia
- Latrodectus
- Other
=Visual Spider Identification
Armed spider (phoneutria nigreventer)
Funnel-web spider (Hadronyche versuta)
.jpg)
Clinical Features
History
- Determine circumstances of bite to assess consistency with spider habitat and behavior
- Indoors vs outdoors
- Day vs night
- Geographic location (recent travel)
- Appearance of the spider if seen
- Dead spiders can be preserved in 70% EtOH and later identified by arachnologists or entomologist
Physical Exam
- No pathognomonic signs proving lesion is a spider bite
- Assess both bite site and for systemic signs
- Bite Site
- Location
- Spider bites more common when clothing is tight against skin
- Number of bites
- Multiple bites suggest parasitic insect and not spider
- Appearance of bite
- Erythema, pallor, hemorrhage, induration, tenderness, paresthesia, vesicles
- Location
- Systemic findings
- Abnormal vital signs (tachycardia possible with black widow)
- Altered mental status
- Abdominal pain
- Diaphoresis
- Generalized rash
- Muscle fasciculations, spasm, or tenderness
Differential Diagnosis
Envenomations, bites and stings
- Hymenoptera stings (bees, wasps, ants)
- Mammalian bites
- Closed fist infection (Fight bite)
- Dog bite
- Marine toxins and envenomations
- Toxins (ciguatera, neurotoxic shellfish poisoning, paralytic shellfish poisoning, scombroid, tetrodotoxin
- Stingers (stingray injury)
- Venomous fish (catfish, zebrafish, scorpion fish, stonefish, cone shells, lionfish, sea urchins)
- Nematocysts (coral reef, fire coral, box jellyfish, sea wasp, portuguese man-of-war, sea anemones)
- Phylum porifera (sponges)
- Bites (alligator/crocodile, octopus, shark)
- Scorpion envenomation
- Reptile envenomation
- Spider bites
Evaluation
Workup
Diagnosis
Management
- Clean area of bite
- Tetanus prophylaxis
- Analgesics
- Hydration
- Surgical follow up if indicated for debridement of necrotic area
- Antivenin is indicated only for specific envenomation
- No proven benefit for corticosteroids
- No indication for antibiotics unless concern for cellulitis
Disposition
See Also
External Links
References
- Boyer LV, Binford GJ, Degan JA. Spider Bites. In Auerbach PS, Cushing TA, Harris NS. Auerbach’s Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017: 993-1016.