Difference between revisions of "Spider bites"

(I added general history, evaluation, and treatment of undifferentiated spider bites)
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* Systemic findings
 
* Systemic findings
 
** Abnormal vital signs
 
** Abnormal vital signs
** Altered mental status
+
** [[Altered mental status]]
** Abdominal pain
+
** [[Abdominal pain]]
 
** Diaphoresis  
 
** Diaphoresis  
** Generalized rash
+
** Generalized [[rash]]
 
** Muscle fasciculations, spasm, or tenderness
 
** Muscle fasciculations, spasm, or tenderness
  
 
==Treatment==
 
==Treatment==
 
* Clean area of bite  
 
* Clean area of bite  
* Tetanus prophylaxis  
+
* [[Tetanus prophylaxis]]
 
* Analgesics  
 
* Analgesics  
 
* Hydration  
 
* Hydration  
 
* Surgical follow up if indicated for debridement of necrotic area   
 
* Surgical follow up if indicated for debridement of necrotic area   
* Antivenom is indicated only for specific envenomation  
+
* [[Antivenin]] is indicated only for specific envenomation  
* No proven benefit for corticosteroids  
+
* No proven benefit for [[corticosteroids]]
* No indication for antibiotics unless concern for cellulitis  
+
* No indication for antibiotics unless concern for [[cellulitis]]
  
 
==See Also==
 
==See Also==

Revision as of 16:52, 26 August 2019

Types

Differential Diagnosis

Envenomations, bites and stings

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

Clinically important spider genera by geographic region

  • North America
    • Loxosceles
    • Latrodectus
    • Tegenaria
  • South America
    • Loxosceles
    • Latrodectus
    • Phoneutria
  • Africa
    • Loxosceles
    • Latrodectus
  • Europe
    • Loxosceles
    • Latrodectus
  • Australia
    • Atrax
    • Hadronyche
    • Latrodectus
  • Asia
    • Latrodectus

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
  • Systemic findings

Treatment

  • 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

See Also

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.