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Spider Bite, Black Widow, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Syndromes caused by envenomation by black widow spider bite

  • Mechanism of toxicity:

    • Females are responsible for human envenomations

    • Venom contains potent neurotoxin, α-latrotoxin:

      • Causes ...

Diagnosis

Signs and Symptoms

History

  • History of spider bite very unreliable and species usually not identified

  • Bite:

    • Described as a pinprick or pinch, if felt at all

  • Local complaints (within minutes of bit...

Treatment

Pre-Hospital

  • ABCs/ACLS

  • Immobilize the wound site and apply cool compresses or ice for comfort during transport to hospital

  • Supportive measures (analgesics, anxiolytics) may be required for pati...

Follow-Up

Disposition

Admission Criteria

  • Pediatric, elderly, pregnant, or symptomatic patients

  • Significant cardiovascular symptoms and signs, or severe HTN, particularly in presence of premorbid cardiac ...

Pearls and Pitfalls

  • Widow bites in infants may present as intractable crying

  • A high fever and WBC count should prompt consideration of alternatives to spider bites (e.g., infection)

Additional Reading

  • Boyer  LV, Binford  GJ, McNally  JT. Spider bites. In: Auerbach, ed. Wilderness Medicine. 5th ed. Philadelphia, PA: Mosby; 2007.

  • Clark  RF, Wethern-Kestner  S, Vance  MV, et al. Cl...

Codes

ICD9

989.5 Toxic effect of venom 

ICD10

T63.311A Toxic effect of venom of black widow spider, acc, init 

SNOMED

  • 217666004 Poisoning due to black widow spider venom (finding)

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