HWN Suggests

Along came a spider

Black widow spider bites, while rare enough in the actual world, are often present at ABEM General. How many know what to do for these patients when they present to the ED? The most common answer given is IV calcium gluconate. Well, according to Clark et al., the NNT is 25 as only 4% got relief with that treatment. Given that it can be caustic to veins, and the benefit is negligible, you probably don’t want to be giving it.

Benzos and opioids are more effective for treatment of the pain and muscle spasm. Antivenin is even more effective, as well as significantly decreasing length of stay in the hospital. However, the cost of the antivenom may be more than the cost of hospitalization,…

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 Beware the Black Widow!

Treatment is usually supportive. Wash the site, then provide pain medicine, muscle relaxants for spasms, and time. There is an antivenin. It is horse-derived and can be useful in the right circumstances, but there are downsides. It has the risk of serum sickness and allergic reactions, including anaphylaxis.

Articles of Interest

'Black widows are super abundant in Phoenix.' Everything to know about these arachnids

While black widows, known for their potent venom, may seem intimidating, these spiders are typically not aggressive and fatalities from their bites are exceedingly rare. It's important to remember that these spiders play a vital role in our ecosystem by helping control insect populations.

Black Widow Envenomation

Analgesia and muscle relaxation is the treatment with opioids and benzos. In severe cases or patients with significant comorbidities, you can give antivenin. Be cautious as 25% of pts will develop anaphylaxis from antivenin and the syndrome is otherwise self-limited.

Clinical Presentation and Treatment of Black Widow Spider Envenomation: A Review of 163 Cases

Superstitions surrounding spiders were reported in Greek mythology, when the jealous goddess Aphrodite transformed Arachne into a spider. In the 17th century, southern Europe experienced a panic over the bite of a spider that is thought to have been a type of wolf spider, Lycosa tarantula, and a dance called a "tarantella" was devised to protect bite victims.

Spider Bites and Summertime Sun

Benzodiazepines are used to treat muscle spasms. Use of black widow spider specific antivenom is associated with reduced duration of symptoms and is usually well tolerated. Unfortunately, this treatment has limited availability due to supply constraints. Administration of intravenous calcium has frequently been recommended. The data on this is limited and one retrospective study of 163 cases found no benefit with calcium. Resolution of symptoms usually occurs over a few days.

The Treatment of Black Widow Spider Envenomation with Antivenin Latrodectus Mactans: A Case Series

Our review of the literature suggests that the witnessed effects of antivenom are usual, which leads us to believe that Antivenin Latrodectus mactans is safe when given correctly.

The World Shifts When a Black Widow Squats

A spider’s web is more than a trap or a home. It is also an extension of the spider’s senses. By paying attention to vibrations traveling through the silken threads, the arachnid can learn about its surroundings.

What Does a Black Widow Spider Bite Feel Like?

If this happens to you, hang in there and ride it out. You will get better, but it takes some time.

What It Feels Like to Get Bitten by a Black Widow Spider

A writer is subjected to one of the most painful experiences known to man, and lives to tell about it.

Widow spider envenomation (latrodectism): A worldwide problem

The literature suggests that antivenin to one species of Latrodectus is likely to be effective against other species. The conclusion drawn was that latrodectism is a common envenomation worldwide.

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StatPearls

The black widow spider species, also known by its biological nomenclature as the Latrodectus species is one of more than 40,000 different species of spiders. Clinically, it is one of most significant species of spiders worldwide. Within the United States, it is responsible for most of the clinically significant envenomation among all species of spiders.