Spider bite

Spider bite
Chelicerae of a black wishbone (nemesiid) spider, a mygalomorph
SpecialtyEmergency medicine
ComplicationsEnvenomation
CausesSpiders

A spider bite, also known as arachnidism, is an injury resulting from the bite of a spider. The effects of most bites are not serious.[1] Most bites result in mild symptoms around the area of the bite.[1] Rarely they may produce a necrotic skin wound or severe pain.[2]: 455 

Most spiders do not cause bites that are of importance.[1] For a bite to be significant, substantial envenomation is required. Bites from the widow spiders involve a neurotoxic venom which produces a condition known as latrodectism.[3] Symptoms may include pain which may be at the bite or involve the chest and abdomen, sweating, muscle cramps and vomiting among others.[1] Bites from the recluse spiders cause the condition loxoscelism, in which local necrosis of the surrounding skin and widespread breakdown of red blood cells may occur.[4] Headaches, vomiting and a mild fever may also occur.[4] Other spiders that can cause significant bites include the Australian funnel-web spider[5] and South American wandering spider.[1]

Efforts to prevent bites include clearing clutter and the use of pesticides.[1] Most spider bites are managed with supportive care such as nonsteroidal anti-inflammatory drugs (including ibuprofen) for pain and antihistamines for itchiness.[6] Opioids may be used if the pain is severe.[6] While an antivenom exists for black widow spider venom, it is associated with anaphylaxis and therefore not commonly used in the United States.[6] Antivenom against funnel web spider venom improves outcomes.[1] Surgery may be required to repair the area of injured skin from some recluse bites.[6]

Spider bites may be overdiagnosed or misdiagnosed.[1] In many reports of spider bites it is unclear if a spider bite actually occurred.[7] Historically a number of conditions were attributed to spider bites. In the Middle Ages a condition claimed to arise from spider bites was tarantism, where people danced wildly.[8] While necrosis has been attributed to the bites of a number of spiders, good evidence only supports this for recluse spiders.[1]

  1. ^ a b c d e f g h i Isbister, GK; Fan, HW (10 December 2011). "Spider bite". Lancet. 378 (9808): 2039–47. doi:10.1016/s0140-6736(10)62230-1. PMID 21762981. S2CID 27408940.
  2. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. pp. 455. ISBN 0-7216-2921-0.
  3. ^ Braitberg, George (2009). "spider bites: Assessment and management" (PDF). Australian Family Physician. 38 (11): 862–67. PMID 19893831. Archived from the original (PDF) on 2013-11-01. Retrieved 2014-04-06.
  4. ^ a b Swanson, DL; Vetter, RS (17 February 2005). "Bites of brown recluse spiders and suspected necrotic arachnidism". The New England Journal of Medicine. 352 (7): 700–07. doi:10.1056/nejmra041184. PMID 15716564.
  5. ^ Isbister, GK; Gray, MR; Balit, CR; Raven, RJ; Stokes, BJ; Porges, K; Tankel, AS; Turner, E; White, J; Fisher, MM (18 April 2005). "Funnel-web spider bite: a systematic review of recorded clinical cases". The Medical Journal of Australia. 182 (8): 407–11. doi:10.5694/j.1326-5377.2005.tb06760.x. hdl:2440/17349. PMID 15850438. S2CID 18066524.
  6. ^ a b c d Kang, JK; Bhate, C; Schwartz, RA (September 2014). "Spiders in dermatology" (PDF). Seminars in Cutaneous Medicine and Surgery. 33 (3): 123–27. doi:10.12788/j.sder.0107. PMID 25577851. Archived from the original (PDF) on 2015-02-14. Retrieved 2015-02-15.
  7. ^ Stuber, Marielle; Nentwig, Wolfgang (2016). "How informative are case studies of spider bites in the medical literature?". Toxicon. 114: 40–44. doi:10.1016/j.toxicon.2016.02.023. PMID 26923161.
  8. ^ Donaldson, LJ; Cavanagh, J; Rankin, J (July 1997). "The dancing plague: a public health conundrum". Public Health. 111 (4): 201–04. doi:10.1016/s0033-3506(97)00034-6. PMID 9242030.