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Spider Bite, Brown Recluse, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

Local or systemic illness caused by brown recluse spider bite envenomation 

Etiology

  • Brown recluse spider (also known as the fiddleback spider) features:

    • Appearance:

      • Delicate body and le...

Diagnosis

Signs and Symptoms

Diagnosis is based not only on the clinical presentation but also on a reliable history of a spider bite. 

History

  • An isolated cutaneous lesion is the most common presentatio...

Treatment

Pre-Hospital

  • Loosely immobilize wound site

  • Elevate the affected extremity

  • Cover bite with cool compresses

  • Transport to hospital when patient experiences immediate onset of symptoms

  • Supportive mea...

Follow-Up

Disposition

Admission Criteria

  • Significant local reaction or signs of systemic toxicity

  • Lower threshold for children, patients with significant comorbidities

Discharge Criteria

  • No evidence of sys...

Pearls and Pitfalls

  • Remember the limited range of brown recluse spiders and the rarity of arachnidism as a cause of necrotic skin wounds

  • In the absence of a reliable spider bite by history, other diagn...

Additional Reading

  • Furbee  RB, Kao  LW, Ibrahim  D. Brown recluse spider envenomation. Clin Lab Med.  2006;26(1):211–226.

  • Mold  JW, Thompson  DM. Management of brown recluse spider bites in primar...

Codes

ICD9

989.5 Toxic effect of venom 

ICD10

T63.331A Toxic effect of venom of brown recluse spider, acc, init 

SNOMED

  • 40119006 poisoning due to brown recluse spider venom (disorder)

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