Edit concept Question Editor Create issue ticket

Black Widow Spider Bite


Presentation

The initial bite of the black widow spider may be unnoticeable to the victim. A mild local pain may be felt at most in adults while infants may present with persistent crying [6]. The autonomic and the neuromuscular signs of spasms and muscle fasciculation sets in after a few hours to few days.

Some patients complain of muscle pain especially in the abdomen with increasing severity in time. These abdominal signs may be coupled by nausea and vomiting in some cases of Latrodectism. Systemic signs of fever, chills and hypertension are the direct effect of the excessive neurotransmitter released from the presynaptic cleft of the neuromuscular junctions which eventually make its way to the bloodstream.

Fever
  • This may cause symptoms such as rash, fever, and joint pain. Home care Apply cold packs to the bite site to ease pain and swelling. You can use a cool wet washcloth.[fairview.org]
  • Dry the area and watch for signs of infection, such as fever, redness, and swelling. When should I contact my healthcare provider? You have increased pain or a change in how your pain feels. You have a fever or a headache.[drugs.com]
  • Kailyn's father thought it was a bug bite that happened to be accompanied by a fever stemming from a cold.[newsweek.com]
Pathologist
  • Medical Editor: Melissa Conrad Stöppler, MD Melissa Conrad Stöppler, MD Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr.[emedicinehealth.com]
Dyspnea
  • […] throbbing at bite site Next 2 to 3 hours: Latrodectism Musculoskeletal symptoms Diffuse, progressive myalgias in 100% of patients Gene ralized sweating Cardiopulmonary symptoms (associated with upper extremity bites) Crampy Chest Pain or chest tightness Dyspnea[fpnotebook.com]
  • The systemic effects and symptoms of black widow envenomation include: severe pain, nausea, tachycardia, myocarditis, hypertension, pyrexia, dyspnea, vomiting, muscle weakness, rigidity, spasm, cramping and tetany, hyperreflexia, paresthesia, salivation[omicsonline.org]
Nausea
  • These abdominal signs may be coupled by nausea and vomiting in some cases of Latrodectism.[symptoma.com]
  • Depending on the amount of venom injected, you might also suffer from fever and chills, nausea and vomiting, muscle aches and destruction of red blood cells (hemolytic anemia).[livestrong.com]
  • The spider is found in many parts of the world Black Widow Spider Bite may occur following contact with a black widow, generally when they are inadvertently disturbed The spider bite is painful and may cause nausea, vomiting, and severe muscle cramps.[dovemed.com]
  • Tremors (shaking), sweating, rapid breathing, weakness, headaches, nausea, and vomiting can also occur. In severe cases, the person may also develop a fast heart rate and high blood pressure.[mountnittany.org]
Vomiting
  • Since vomiting is a symptom of a black widow spider bite, if the cat has eaten the spider and then vomits it up, it takes the guesswork out of what's wrong with the cat and, more importantly, the species of the sneaky spider.[pets.thenest.com]
  • If possible, take a sample of your dog's stool and/or vomit with you to the veterinary clinic, this can help your doctor to make the diagnosis that much faster.[petmd.com]
  • These abdominal signs may be coupled by nausea and vomiting in some cases of Latrodectism.[symptoma.com]
  • If a spider was vomited up, bring it with you. In cases where this visual aid is not available, a diagnosis will be made based on symptoms and other clinical signs.[wagwalking.com]
Abdominal Pain
  • Investigators reviewed their medical records and categorized symptom severity as mild (asymptomatic or local pain only, 9%), moderate (muscle or abdominal pain with normal vital signs, 37%), or severe (generalized back, chest, or abdominal pain; nausea[mdedge.com]
  • Other symptoms include muscle cramps all over the body and severe abdominal pain. Tremors (shaking), sweating, rapid breathing, weakness, headaches, nausea, and vomiting can also occur.[mountnittany.org]
  • The local pain may be followed by localized or generalized severe muscle cramps, abdominal pain, weakness, and tremor. In severe cases, nausea, vomiting, faintness, dizziness, chest pain, and respiratory difficulties may follow.[medicinenet.com]
Severe Abdominal Pain
  • Other symptoms include: Muscles that begin to hurt and become stiff, usually within 8 hours Nausea or vomiting Difficulty breathing Severe abdominal pain or cramping Excessive sweating Rash and itching Swollen eyelids Weakness or tremors.[webmd.com]
  • Other symptoms include muscle cramps all over the body and severe abdominal pain. Tremors (shaking), sweating, rapid breathing, weakness, headaches, nausea, and vomiting can also occur.[mountnittany.org]
  • You have severe abdominal pain. Your wound turns blue or black and smells foul. Your muscles become stiff and start to cramp or spasm. You have tremors or trouble breathing, talking, or walking. Your heart is racing.[drugs.com]
Acute Abdomen
  • Mimics of black widow envenomation may include scorpion and snake bites, an acute abdomen, myocardial infarction, alcohol withdrawal, organophosphate poisoning and tetanus.[tandfonline.com]
  • Victims also may have significant hypertension, autonomic and central nervous system dysfunction, and abdominal pain severe enough to be mistaken for an acute abdomen. 2 Our literature search didn’t find any RCTs comparing the efficacy of general symptomatic[mdedge.com]
  • Latrodectism can be confused with an acute abdomen secondary to the significant muscle cramping and abdominal rigidity that can occur with a black widow spider bite.[clinicaladvisor.com]
  • Severe cases of latrodectism should be distinguished from acute abdomen, rabies, or tetanus. Spiders are identified by location and markings.[msdmanuals.com]
Hypertension
  • A bite may manifest with a clinical syndrome of headache, nausea, vomiting, muscle cramping, joint stiffness, hypertension and diaphoresis otherwise known as Latrodectism.[symptoma.com]
  • The widow venom, a powerful neurotoxin known as a-latrotoxin, causes muscle pain, diaphoresis, tachycardia, flushing, and hypertension. Treatment is usually symptomatic with a combination of opioid analgesics and muscle relaxants.[ncbi.nlm.nih.gov]
  • Within minutes to hours of the bite, victims may develop localized pain, which may further progress to intense muscle spasms, nausea, vomiting, tachycardia, and hypertension.[nursingcenter.com]
  • Hypertension and tachycardia may occur in children. What's your assessment? David's history, description of the spider, and signs and symptoms lead you to suspect he was bitten by a black widow.[journals.lww.com]
  • Victims also may have significant hypertension, autonomic and central nervous system dysfunction, and abdominal pain severe enough to be mistaken for an acute abdomen. 2 Our literature search didn’t find any RCTs comparing the efficacy of general symptomatic[mdedge.com]
Tachycardia
  • The widow venom, a powerful neurotoxin known as a-latrotoxin, causes muscle pain, diaphoresis, tachycardia, flushing, and hypertension. Treatment is usually symptomatic with a combination of opioid analgesics and muscle relaxants.[ncbi.nlm.nih.gov]
  • Hypertension and tachycardia may occur in children. What's your assessment? David's history, description of the spider, and signs and symptoms lead you to suspect he was bitten by a black widow.[journals.lww.com]
  • Within minutes to hours of the bite, victims may develop localized pain, which may further progress to intense muscle spasms, nausea, vomiting, tachycardia, and hypertension.[nursingcenter.com]
  • On examination he had a mild tachycardia. Muscle spasm was evident. He was flushed, sweaty and anxious (Figure 3 ).[tandfonline.com]
  • Hypertension, Tachycardia ) Headache Nausea and Vomiting References Clark (1992) Ann Emerg Med 21(7): 782-7 [PubMed] X. Differential Diagnosis XI.[fpnotebook.com]
Increased Sweating
  • Symptoms of a black widow bite can include anxiety, difficulty breathing, painful muscle cramps, headache, high blood pressure, increased saliva, increased sweating, sensitivity to light, muscle weakness, nausea and vomiting, numbness, and restlessness[refinery29.com]
  • In general, the signs and symptoms may include: Sharp pain at the bite site Severe muscle cramps from effects of the toxin/venom Nausea and vomiting Drooling and increased sweating General weakness Light-sensitivity Neurological symptoms including anxiety[dovemed.com]
  • Symptoms of a typical spider bite can include; Itching or rash Pain radiating from the site of the bite Muscle pain or cramping Reddish to purplish color or blister Increased sweating Difficulty breathing Headache Nausea and vomiting Fever Chills Anxiety[health.hawaii.gov]
  • The following symptoms can also occur: Anxiety Difficulty breathing Headache High blood pressure Increased saliva Increased sweating Light sensitivity Muscle weakness Nausea and vomiting Numbness and tingling around the bite site, then sometimes spreading[medlineplus.gov]
Cold, Clammy Skin
  • In more serious cases, a weak pulse, cold clammy skin, unconsciousness, or convulsions may occur. Treating a Black Widow Spider Bite If you get bit, remain calm.[tripsavvy.com]
Muscle Cramp
  • Various medications are used to treat the muscle cramps, spasms and pain caused by a bite. Black widow spider antivenin is seldom necessary.[desertusa.com]
  • The spider is found in many parts of the world Black Widow Spider Bite may occur following contact with a black widow, generally when they are inadvertently disturbed The spider bite is painful and may cause nausea, vomiting, and severe muscle cramps.[dovemed.com]
  • The local pain may be followed by localized or generalized severe muscle cramps, abdominal pain, weakness, and tremor. In severe cases, nausea, vomiting, faintness, dizziness, chest pain, and respiratory difficulties may follow.[medicinenet.com]
Myalgia
  • Myalgias and muscle spasms resulting from widow spider bites respond poorly to muscle relaxants and calcium salts. Symptomatic envenomation is initially treated supportively.[msdmanuals.com]
  • Symptoms Initial Bite felt as pinprick with minimal initial pain First 10 to 20 minutes Pain and throbbing at bite site Next 2 to 3 hours: Latrodectism Musculoskeletal symptoms Diffuse, progressive myalgias in 100% of patients Gene ralized sweating Cardiopulmonary[fpnotebook.com]
Muscle Twitch
  • Signs That a Dog Has a Black Widow Spider Bite Dogs that have been bitten by a black widow spider and had venom injected into them may display the following signs: Rigid abdominal muscles Difficulty breathing Muscle twitches Restlessness High blood pressure[doghealth.com]
Joint Stiffness
  • A bite may manifest with a clinical syndrome of headache, nausea, vomiting, muscle cramping, joint stiffness, hypertension and diaphoresis otherwise known as Latrodectism.[symptoma.com]
Headache
  • Symptoms of a black widow bite can include anxiety, difficulty breathing, painful muscle cramps, headache, high blood pressure, increased saliva, increased sweating, sensitivity to light, muscle weakness, nausea and vomiting, numbness, and restlessness[refinery29.com]
  • Other signs of a black widow spider bite include: Rigid muscles in the shoulders, chest, back, and abdomen Restlessness Anxiety Dizziness Headache Excessive sweating Weakness Drooping or swelling of the eyelids Continue Learning about First Aid For Animal[sharecare.com]
  • An ulcer or blister that turns black Headache and body aches Rash Fever Nausea or vomiting The symptoms of a brown recluse spider bite may look like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.[cedars-sinai.org]
Dizziness
  • In severe cases, nausea, vomiting, faintness, dizziness, chest pain, and respiratory difficulties may follow. The severity of the reaction can depend on the age and physical condition of the person bitten.[medicinenet.com]
  • Other signs of a black widow spider bite include: Rigid muscles in the shoulders, chest, back, and abdomen Restlessness Anxiety Dizziness Headache Excessive sweating Weakness Drooping or swelling of the eyelids Continue Learning about First Aid For Animal[sharecare.com]
  • You could see he had tummy ache, dizzy and I let him feel on the side of his body you could feel something like sists. He then test his kidney's - and the colour of his urine was like brown red yellow - very difficult to explain.[wagwalking.com]
  • More severe symptoms include – nausea, dizziness, chest pain and respiratory distress. Elevated heart rate and blood pressure that can lead to more serious complications. Responding to bites Black widow spider bites should not be taken lightly.[terminix.com]
Seizure
  • If the veterinarian suspects a black widow bite, treatment can include: IV treatment with antivenin Monitoring and treating for seizures Watching for and treating high blood pressure Muscle relaxers and pain medications if needed Treating low blood sugar[doghealth.com]
  • […] heart rate Drooling or excessive salivation Vomiting Diarrhea Restlessness Seizures Death Types Widow spiders come in several types, all of which contain powerful venom that acts as a neurotoxin.[wagwalking.com]
  • In some instances, seizures and shock can develop. Symptoms peak two to three hours after onset but can last several days.[livestrong.com]
  • Your cat needs to be taken to a veterinary hospital immediately, where they may need to provide oxygen treatment, intravenous fluid therapy, muscle relaxants, pain killers, anti-seizure medications, and anti-venom. Works Cited David R. Nelsen, W.[cathealth.com]
  • […] to paralysis of the diaphragm nausea chills a severe increase in blood pressure a headache, which may be partially due to a change in blood pressure sweating weakness a fever In rare and extreme cases, black widow spider venom poisoning may lead to seizures[healthline.com]
Confusion
  • The spider is particularly prevalent in the Southwest, Southeast and California, and symptoms from its bite are painful and may be confusing to clinicians.[ncbi.nlm.nih.gov]
  • SWNS:South West News Service Spider experts compared the painful bite to a harmless bee or wasp sting but doctor's said it was toxic Confused as to why his bite hadn't healed, Matt researched his symptoms.[thesun.co.uk]
  • Call the Poison Center for additional information or if you are confused about what to do: Poison Centers across the country now have a new national emergency phone number - 1-800-222-1222 Or visit their web site: Common Questions: How to identify a black[desertusa.com]
  • False widows ( Steatoda sp.) are sometimes confused for black widow spiders ( Latrodectus sp.) and are mistakenly thought to be as dangerous. Both have a similar dark-coloured, globular body.[nhm.ac.uk]
  • Cobweb spiders that are most easily confused with widows are in the genus Steatoda. These cob web spiders are similarly black and have the same enlarged abdomen as widow spiders.[extension.colostate.edu]
Agitation
  • Removing them by hand will agitate them and bite in self-defense. When it is totally necessary to study them, one should use protective gloves and the proper instruments in handling them.[symptoma.com]
  • However, while patients with an acute abdomen often prefer to lie quite still, patients suffering from latrodectism are often agitated, hypertensive, and unable to find a comfortable position.[clinicaladvisor.com]
  • However, agitation of the spider may cause it to throw needle-like hairs.[msdmanuals.com]
  • These signs include muscle pain and cramping, vomiting, diarrhea, tremors, and agitation. Affected dogs and cats may also develop muscle rigidity and may seem painful in their abdomen (belly).[vcahospitals.com]
  • The most common symptoms after a bite (besides the pain of the bite itself) are: Abdominal pain Muscle cramps/soreness Soreness and redness around the bite Irritability/agitation High blood pressure is also common from black widow spider bites, although[verywellhealth.com]

Workup

The diagnosis of the Latrodectus bite may require a detailed history of the incident with detailed account on the part of the eyewitnesses. The accurate chronology of the clinical signs can aid in the actual diagnosis of the arachnid bite. When the spider specimen is available, experts may be called in to identify the species of the spider.

Black widow spiders have the characteristic shiny black body with large rounded abdomen, it has the red hourglass mark at the ventral abdomen, and a general body length measure of 11 to 13 cm.

Blood tests may show increased polymorphonuclear activity with eosinophilia but are relatively inconclusive. The serum Creatine Kinase (CK) markers are usually elevated [7].

Treatment

The pre-hospital treatment of the black widow spider bite includes the washing and cleaning of the bite site with soap and water.

Suspicion of envenomation may benefit from a tourniquet at the upper portion of the bitten limb to impede circulation of the venom to distal organs. The affected extremity is elevated to slow down the spread of the venom. Oral analgesics like aspirin and acetaminophen may relieve signs of pain. The introduction of the antivenom in the field is grossly discouraged with the fear of serious allergic reactions [8].

It is important to bring the specimen of the spider to the hospital along with the patient for proper identification. Hospital phase of treatment is geared towards supportive care of the airways and cardiac support. Antivenoms should be considered when there is there is an eminent threat in pregnancy, loss of limb and patient has refractory tolerance to pain [9].

Prognosis

In general, bites from the black widow spider are self-limiting without intervention. The antivenom may shorten the bothersome clinical course which may debilitate the patient for a few days to weeks if left untreated.

Rare cases of fatal bites may result to bronchorhea and pulmonary edema especially when there are allergic reactions involved in the immune response.

Complications

It is well established that there are very rare instances where a black widow spider bite may cause complications and may even lead to death. Most of these cases involve the very young and the very old segments of the population with concomitant illnesses.

In allergic reactions in the bronchus, severe phlegm formation may clog the airways and cause difficulty in breathing. The autonomic dysfunction of the diaphragm puts the patient at risk for pulmonary edema which could be fatal if not brought to hospital attention.

Etiology

To determine the definitive cause of the spider bite and dictate the course of treatment, one must be keen in identifying the offending spider.

The black widow spider has distinct marking in the ventral abdomen in a shape of an hourglass. This red-orange symbol is clearly visible in the shiny black body of the arachnid. The female widows are the only ones capable of envenominating humans measuring from half to one inch long. It is also noteworthy that not all venomous Latrodectus are black, the Latrodecus geometricus are brown which are also found in North America and the red back widow or Latrodectus hasselti which are endemic in Australia.

Epidemiology

Widow spider bites number to approximately 2300 bites in the year 2012 according to the Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS) [3]. Almost all of the bites recorded in the US at that time were not serious and non-fatal since 1983.

The American Association of Poison Control Centers has given an estimated average of 2500 widow spider bites per year in the United States [4]. The known average of widow spider death in the United States since was 4 deaths per year [5].

Sex distribution
Age distribution

Pathophysiology

The venom of the Latrodectus spider is virtually a neurotoxin identified as the alpha-Latrotoxin which affect the neuromuscular junctions in the presynaptic end and opens cation channels to release myriads of neurotransmitters.

The excessive neurotransmitters in the blood stream causes the clinical manifestations like the spastic cramping of abdomen and stiffness of the extremities. Other autonomic implication of the neurotoxins are the persistent pain and hypertension associated with the black widow spider bite.

Prevention

The Latrodectus spider only bites humans in defense and when its habitat is disturbed. The main objective of the black widow spider bite prevention is to lower down contact between spiders and human.

Useful tips include:

  • Wearing of gloves, long sleeves and hat when visiting the attic, sheds and untouched parts of the garage.
  • Shake off clothing, cloves and shoes which were not used for a while.
  • Insect proofing the house with repellants and the installation of tight screen fixtures.
  • Keeping stored items elevated from the floor while discarding old boxes and other unwanted effects where the spiders may live.
  • Vacuuming spiders and webs by placing them in a sealed plastic container to prevent them from inhabiting back in the house.

Summary

The Latrodectus mactans mactans or black widow spiders can inflict a noxious bite to humans that can cause a number of symptoms. A bite may manifest with a clinical syndrome of headache, nausea, vomiting, muscle cramping, joint stiffness, hypertension and diaphoresis otherwise known as Latrodectism [1].

Envenomation from dangerous spiders are relatively rare thus, the identification of the biting arachnid is paramount in the anti-venom vaccination of the patient. Black widow spiders lives in dirty places with minimal movement and lots of flies, more commonly in the attics, garage, outhouse, sheds and foliage where they usually come in contact with humans [2].

Patient Information

It is imperative that one should respect these spiders especially when found in their habitat. Removing them by hand will agitate them and bite in self-defense. When it is totally necessary to study them, one should use protective gloves and the proper instruments in handling them.

The female black widow spiders are the ones responsible for envenomation and are active during night time because they are nocturnal hunter [10].

References

Article

  1. Hoyte CO; Cushing TA; Heard KJ. Anaphylaxis to black widow spider antivenom Am J Emerg Med. 2012; 30(5):836.e1-2 
  2. Boyer Hassen LV, McNally JT, Binford GJ. Spider bites. In: Auerbach PS, ed. Wilderness Medicine. 4thed. St. Louis: Mosby-Year Book; 2001:807-838.
  3. Mowry JB, Spyker DA, Cantilena LR Jr, Bailey JE, Ford M. 2012 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 30th Annual Report. Clin Toxicol (Phila). Dec 2013;51(10):949-1229
  4. Bronstein AC, Spyker DA, Cantilena LR Jr, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS). Clin Toxicol (Phila). Dec 2007;45(8):815-917
  5. Langley RL, Morrow WE. Deaths resulting from animal attacks in the United States. Wilderness Environ Med. Feb 1997;8(1):8-16. 
  6. Woestman R, Perkin R, Van Stralen D. The black widow: is she deadly to children?. Pediatr Emerg Care. Oct 1996;12(5):360-4. 
  7. Clark RF, Wethern-Kestner S, Vance MV, Gerkin R. Clinical presentation and treatment of black widow spider envenomation: a review of 163 cases. Ann Emerg Med. Jul 1992;21(7):782-7. 
  8. Allen RC, Norris RL. Delayed use of widow spider antivenin. Ann Emerg Med. Sep 1995;26(3):393-4.
  9. Cohen J, Bush S. Case report: compartment syndrome after a suspected black widow spider bite. Ann Emerg Med. Apr 2005;45(4):414-6. 
  10. Bush SP, Naftel J. Injection of a whole black widow spider. Ann Emerg Med. Apr 1996;27(4):532-3.

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!
Last updated: 2019-07-11 20:41