Difference between revisions of "Spider bites"

Line 54: Line 54:
 
*** Erythema, pallor, hemorrhage, induration, tenderness, paresthesia, vesicles
 
*** Erythema, pallor, hemorrhage, induration, tenderness, paresthesia, vesicles
 
* Systemic findings
 
* Systemic findings
** Abnormal vital signs
+
** Abnormal vital signs ([[tachycardia]] possible with black widow
 
** [[Altered mental status]]
 
** [[Altered mental status]]
 
** [[Abdominal pain]]
 
** [[Abdominal pain]]
Line 64: Line 64:
 
* Clean area of bite  
 
* Clean area of bite  
 
* [[Tetanus prophylaxis]]  
 
* [[Tetanus prophylaxis]]  
* Analgesics  
+
* [[analgesia|Analgesics]]
 
* Hydration  
 
* Hydration  
 
* Surgical follow up if indicated for debridement of necrotic area   
 
* Surgical follow up if indicated for debridement of necrotic area   

Revision as of 21:58, 28 September 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

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.