Approach to the patient with a suspected spider bite: An overview
- Richard S Vetter, MS
Richard S Vetter, MS
- Department of Entomology
- University of California, Riverside
- David L Swanson, MD
David L Swanson, MD
- Associate Professor of Dermatology
- Mayo Clinic
- Section Editors
- Daniel F Danzl, MD
Daniel F Danzl, MD
- Section Editor — Environmental Emergencies
- Professor of Emergency Medicine
- University of Louisville School of Medicine
- Stephen J Traub, MD
Stephen J Traub, MD
- Section Editor — Toxicology
- Associate Professor of Emergency Medicine
- Mayo Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Spider bites are rare medical events. Of the thousands of spider species that exist around the world, only a handful causes problems in humans . There are a variety of more common disorders that can mimic a spider bite, some of which represent a far greater threat to the patient if not recognized and treated appropriately.
Thus, accurate diagnosis is the initial goal of the clinician evaluating a patient with a lesion that might represent a spider bite. Discerning among the various conditions in the differential diagnosis of a spider bite requires familiarity with these disorders, as well as a basic understanding of the distribution and behavior of medically important spiders.
The spiders of medical importance, an overview of the clinical manifestations of their bites, and diagnosis and differential diagnosis of spider bites will be reviewed here. The assessment and management of spider bites caused by recluse and widow spiders are discussed separately. (See "Bites of recluse spiders" and "Clinical manifestations and diagnosis of widow spider bites", section on 'Clinical manifestations' and "Management of widow spider bites".)
MEDICALLY IMPORTANT SPIDERS
Spiders are arachnids (a group of arthropods), which have four pairs of legs, similar to scorpions, mites, and ticks (figure 1). They use sharp fangs at the end of their chelicerae to bite prey (typically insects, other arthropods, or small vertebrates) and inject venom.
Most spiders pose no threat to humans. The venom of most spiders has little or no effect on mammalian tissues [2,3]. In addition, only a few species have cheliceral muscles powerful enough to penetrate human skin, and most of these spiders bite humans only in rare and extreme circumstances (eg, as they are being fatally crushed between skin and some object).
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- MEDICALLY IMPORTANT SPIDERS
- Widow spiders
- False black widow spiders
- Recluse spiders
- Australian funnel web spiders
- South American Phoneutria
- Yellow sac spiders
- TYPES OF REACTIONS
- Local reactions
- Necrotizing local reactions
- Systemic reactions
- Urticating hairs and allergic reactions
- Influence of geographic location
- Laboratory data
- DIFFERENTIAL DIAGNOSIS
- Other bites and stings
- Other common dermatoses
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS